After Wisdom Tooth Removal

Having impacted wisdom teeth removed is a serious surgery. You must follow the post-operative instructions for your care to avoid potential complications such as infection or increased pain and swelling.

Immediately Following Surgery

  • Keep the gauze pad placed over the surgical site in place for 30 minutes, after which it should be removed and discarded
  • Avoid vigorous mouth-rinsing or touching the surgery site as this can dislodge the blood clot forming over the wound
  • Take the medications prescribed by Dr. Davies as soon as you begin to feel discomfort, which generally happens around the time the anesthetic starts to wear off
  • Limit your activities on the day of surgery. It is okay to resume them the following day or when you begin feeling comfortable
  • Place ice packs on your cheeks over the surgery site. Refer to the section, below, about swelling for further information

Bleeding
You may notice some moderate bleeding, redness, or oozing in your mouth and saliva for the first 24 hours after your wisdom tooth removal. If you experience excessive bleeding (mouth filling with blood), you can control this by gently biting on a gauze pad placed over the wound for 30 minutes. This can be repeated if necessary.

Additionally, you can gently bite down on a moistened tea bag for 30 minutes to reduce bleeding. The tannic acid in tea aids your body in forming a blood clot by contracting the blood vessels. If this excessive bleeding continues, please call our office for instructions.

Swelling
Swelling after surgery is not uncommon and can be expected around the mouth, cheeks, eyes, and sides of the face. You may not notice this until the day after the surgery, and it will reach its peak around 2-3 days afterward. To minimize the swelling, place ice packs or baggies of ice on each side of the face immediately following surgery for the first 36 hours, after which it will not have much effect. The ice packs can be left on continuously while you’re awake. After 36 hours post-surgery, you can switch to moist heat, which will continue to reduce swelling. Swelling and jaw stiffness several days after surgery are also normal and are no cause for alarm.

Pain
As soon as your anesthetic begins to wear off, you should start taking pain medication. If you are experiencing moderate pain, 1 or 2 Tylenol or Extra Strength Tylenol can be taken every 3-4 hours. If you prefer, ibuprofen (Advil or Motrin) can be taken instead. Ibuprofen bought over-the-counter comes in 200 mg tablets; 2-3 tablets can be taken every 3-4 hours.

If you are in severe pain, take the medication prescribed by Dr. Davies as directed. This pain medication may make you feel tired or groggy. Do not operate a vehicle or machinery while taking them. Avoid alcoholic beverages. The pain or discomfort after surgery should become less each day. If the pain persists or grows worse, it may require attention, and you should call the office.

If you are allergic to any of the above medications or have otherwise been instructed not to, do not take them.

Diet
Initially, you should only take in liquids after being under general anesthesia or I.V. sedation. You should avoid straws and drink directly from the glass instead. The sucking motion required to use a straw can easily dislodge the blood clot that forms after surgery. Dehydration can happen very quickly and will slow your recovery, so it’s essential to drink plenty of fluids – at least 5 to 6 glasses every day.

You can eat soft foods, but care should be taken to eat in areas of the mouth away from the surgical site(s). Since you will likely be eating a little less than usual, it is important to consume nutritious, high calorie, high protein foods to maintain your strength and help with healing. You should continue to eat as regularly as possible and avoid skipping meals. If you have additional questions about diet, refer to the end of the brochure, which has a section on suggested diet instructions.

Caution: After surgery, sitting or standing suddenly from a lying position can cause dizziness. Be sure to sit slowly, and continue sitting for at least 1 minute before attempting to stand.

Oral Hygiene
You should not rinse in any way until the day after your surgery. Brushing your teeth the night of surgery is acceptable, but rinsing should be done very carefully to avoid dislodging the blood clot forming over your surgery site.

The day after surgery you should start rinsing with warm salt water (one teaspoon of salt dissolved in a cup of warm water) at least 5-6 times per day. Rinsing is especially important after meals and snacks.

Discoloration
Discoloration of the skin is not uncommon following swelling. Because blood from swelling will begin to disperse under the skin, you may notice some black, blue, green, or yellow bruising. This discoloration is a regular occurrence after surgery, but may not appear until 2-3 days later. To speed up the removal of discoloration, you can apply moist heat to the area.

Antibiotics
If you have been prescribed antibiotics, take them as directed. You must complete the entire prescription as directed, even if you feel well. Only discontinue in the event of a rash or other reaction. If you have any questions, please call our office.

Nausea and Vomiting
If you begin feeling nauseated or vomit, avoid taking anything by mouth (including prescribed medications) for at least one hour. We recommend slowly sipping ginger ale, cola, or tea over 15 minutes. After the nausea subsides, you can resume eating solid foods and taking the prescribed medications.

Other Complications

  • Numbness in the lip, cheek, and tongue are completely normal and temporary and should be no cause for alarm. You might not be able to feel if you bite one of these areas, so extra care should be taken until you can feel them again. If you have any questions, give us a call.
  • Immediately following surgery, you may have a slightly elevated temperature. This is also common and can be managed with Tylenol or ibuprofen. If the fever persists, please notify our office.
  • After the surgery, you might feel lightheaded or dizzy. This will be intensified by the fact that you weren’t allowed to eat or drink before surgery. Sitting or standing up suddenly from a lying position can cause dizziness. Be sure to sit up slowly, and continue sitting for at least 1 minute before attempting to stand.
  • Sometimes, patients report feeling hard projections in their mouth following wisdom tooth removal surgery. These are not roots, but rather the boney walls that supported the tooth. Over time they generally smooth out on their own, but if not, or if they are especially bothersome, Dr. Davies can remove them.
  • During surgery, the corners of your mouth were probably stretched a little bit, which can lead to cracking or dryness. We recommend keeping them moist with an ointment like Vaseline.
  • You may experience a sore throat and pain when swallowing. This is mostly due to the swelling in the throat muscles and should subside within 2-3 days.
  • Jaw muscle stiffness is also not uncommon following oral surgery and may lead to difficulty opening your mouth for a few days. It is a normal reaction and will resolve on its own.

Finally
Sometimes the sutures placed after surgery to minimize bleeding and aid in healing may become dislodged. This is no cause for alarm – simply remove the suture from your mouth and discard it. Sutures are typically removed one week after your surgery and requires no needles or anesthesia. It is a quick procedure – only about 1 minute, or so – and causes no discomfort.

Pain and swelling should begin to diminish with each day that passes after surgery. If at any time it begins to worsen or if unusual symptoms appear, please call our office for further instructions.

Where we removed the tooth, there will be a cavity left behind. This cavity will begin to fill with tissue as it heals over the next month. During this time, extra care should be taken to keep the area clean, especially after meals. You can do this by rinsing with warm salt water or brushing gently.

A dry socket may occur if the blood clot becomes dislodged prematurely from the tooth socket. Symptoms may include pain at the surgical site or ear pain, even 2-3 days post-surgery. If this happens, call the office.

No two mouths are alike, and your case is individual. While others may offer some well-intended advice, we recommend that you discuss any problems with those best able to help you: Dr. Davies or your family dentist.

It is okay to brush your teeth, but be gentle around the surgical site.

Regular exercise routines may have to wait until you’ve fully recovered due to decreased nourishment and increased risk of dizziness or lightheadedness. Exercise may exacerbate these things, and care should be taken to reintroduce exercise slowly. If you feel lightheaded while exercising, stop. This will reduce the chances of injury.