After Wisdom Tooth Removal

Post-operative care is very important to avoid any potential problems. 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 position for 30 to 60 minutes. After this time, the gauze pad should be removed and discarded. Replace the pad if bleeding persists. Do not go to sleep with the pads. They can block your airway!
• 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 two hours after surgery or as directed by Dr. Albright. This will usually coincide with the local anesthetic becoming diminished.
  
• Restrict your activities the day of surgery and 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 or sit upright, and avoid exercise. If bleeding does not subside, call our office for further instructions.

Swelling

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 2-3 days post-operatively. 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 intermittently for the first 24 hours (20 minutes on/ 20 minutes off). After 24 hours, ice has no beneficial effect. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery. Twenty-four hours following surgery, the application of heat to the sides of the face is beneficial in reducing the size of the swelling. If you are using a heating pad, please use it on the low setting to avoid burning your skin.

Pain

In most circumstances, pain medication will be prescribed post-operatively. Please follow the instructions on the prescription. We advise you take your medication with food (to avoid nausea) and within two hours of your procedure to minimize discomfort. The prescribed pain medicine will make you groggy and will slow down your reflexes. Do not drive an automobile or work around machinery. Please make sure small children cannot obtain your mediation! Avoid alcoholic beverages. Most of our patients have minimal post-operative pain. Pain or discomfort following surgery should subside more and more every day. If pain persists past two or three days please contact our office as all of your follow up visits are included in your surgery fee. We are relying on you to communicate with us. It is our goal for this to be a very pleasant experience for you.

Nutrition

After general anesthetic or I.V. sedation, liquids should be taken at first. 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 from the surgical sites. High calorie, high protein intake is very important. 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. Therefore, immediately following surgery, if you are lying down, make sure you sit for one minute before standing.

Keep the mouth clean

No rinsing of any kind should be done until the day following surgery. You can brush your teeth the night of surgery but rinse gently. 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. If you are unable to eat salt, please rinse with mouthwash and water. A syringe may be given to you at the time of your surgery to help keep the extraction site(s) clean. If you are given a syringe, start using it on the second day following surgery using the directions you were given in our office.

Discoloration

In some cases, discoloration of the skin follows swelling. Some patients, especially those on a medications or who are elderly, may be experience bruising. This is a normal response following surgery, which may occur 2-3 days post-operatively.

Antibiotics

If you have been prescribed antibiotics, take the tablets or liquid as directed. Antibiotics will be prescribed to help prevent infection. Discontinue antibiotic use in the event of a rash, itching, rapid swelling, diarrhea or other unfavorable reaction. Call the office if you have any questions.

Nausea and Vomiting

In you undergo anesthesia, Dr. Albright administers anti-nausea medication through your IV but this does not mean you will not have nausea post-operatively as many medications cause nausea, particularly on an empty stomach. Normally you will be prescribed anti-nausea medication if you are prescribed pain medication. Take anti-nausea medication if you become nauseous. Please be aware that anti-nausea medication may make you sleepy; be sure to rest. If you have any questions, please contact our office.

Other Possible 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 it, so be careful. Call the office if you have any questions about this.

Slight elevation of temperature immediately following surgery is not uncommon especially when you are behind in oral fluid intake. If the temperature persists, please notify our office.

You should be careful going from the lying down position to standing. You could get light headed when you stand up suddenly. Before standing up, you should sit for one minute then get up. This can be true when going to the bathroom.

Occasionally, patients may feel hard projections in the mouth with their tongue. Please avoid feeling around your mouth with your tongue or fingers. They are not roots or teeth remnants. They are the bony walls which supported the tooth. If you have concerns about this, please contact our office.

Dr. Albright puts a moisturizer on your lips and the corners of your mouth during surgery. You may continue this after surgery.

Stiffness (Trismus) of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. To avoid stiffness after surgery, please avoid clenching your jaw and practice stretching exercises by placing your fingers in between your upper and lower teeth. This is a normal post-operative event which will resolve in time.

Finally

Occasionally sutures are placed in the area of surgery to minimize post-operative bleeding and to help healing. Sometimes they can become dislodged. This is no cause for alarm. Just remove the suture from your mouth and discard it. The sutures will resorb on their own in 7-10 days; however, if they become bothersome, please contact our office so that we can remove them for you. Suture removal is a very simple procedure and does not require anesthesia.

The pain and swelling should subside more and more each day following surgery. If your post-operative pain or swelling is not better by the second day following the procedure or unusual symptoms occur, call our office for instructions.

Remember there will be a hole 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 saltwater rinses or a toothbrush. Usually a monoject or small, curved-tip syringe will be given to remove this debris. Our office will advise you of how to use this. It is extremely easy to use.

Your case is individual, no two mouths are alike. Do not take seriously well-intended advice from friends. Discuss your concerns with the person best able to effectively help you: Dr. Albright. Remember that he is going to know your situation better than anyone else.

Brushing your teeth is okay - just be gentle at the surgical sites. Be careful if you are still numb.

A dry socket is when the blood clot does not form or 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. If this occurs, please call our office because treatment is very simple. It does not require anesthesia and you will feel immediate relief. You will not need a ride for this treatment. We want to make this a very pleasant experience for you so please call us with any concerns or questions.

If you are involved in regular exercise, we request you avoid jogging and weight lifting for 3 days following surgery. Walking, yoga and swimming are okay to do.