After Wisdom Tooth Removal
Home Instructions After Wisdom Teeth Extraction
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.
DAY OF SURGERY:
- Bite down firmly on the provided gauze until the bleeding stops. If there is still some bleeding at 30 minutes, replace with new gauze that has been slightly dampened with cool water. Proper placement will help you not swallow blood, which can make you nauseated. When gauze pads have little or no blood on them, they are no longer necessary. The amount of bleeding will vary from person to person. If bleeding persists past 2 to 3 hours and is not decreasing, moisten a tea bag (no herbal teas), place it over the extraction site(s), and bite down with pressure. Hold still for 30 minutes. The tannin in the tea helps to clot blood. Do not rinse on the day of surgery; it may prolong your bleeding.
- Discomfort is normal after the extraction of teeth. If you are not allergic or intolerant to non-steroidal anti-inflammatory drugs (NSAIDs), start taking ibuprofen (also known as Advil® or Motrin® max. daily dose 3200mg) AND acetaminophen (Tylenol® max. daily dose 3000mg) combined on a regular basis, as directed on the labels. If your pain is not controlled by this combination alone, take the Ibuprofen and your prescribed narcotic together. Be certain to take your pain medications with food; this will help prevent nausea. Remember, narcotic pain medicine will impair your judgment and reflexes, and can cause constipation.
- Diet: cold soft foods are to be eaten the day of surgery (Milkshakes, yogurt, ice cream, cold pureed soups, etc.) Do not use a straw to drink liquid beverages.
- Patients who have had general anesthesia should have a responsible adult stay with them for 6-8 hours following surgery or until the patient no longer feels sleepy from anesthesia. The surgical site(s) may be numb for 4-8 hours if a long-acting local anesthetic was given. Patients who have had general anesthesia may not drive for 24 hours following surgery.
- Swelling is normal after surgery and is a major cause of post-extraction discomfort. Swelling typically peaks by the third day and then starts to resolve. For up to 48 hours after surgery, a cold compress should be used for reduction of pain and swelling. Place the ice pack(s) on the outside of your face at 15-minute intervals. Also, keep your head elevated on 2 pillows for 2–3 days. These measures will not eliminate swelling, but they help to reduce its severity.
- Do not smoke for at least a week. Smoking will increase your bleeding. The nicotine and tar in tobacco impair healing and is likely to cause a “dry socket” (slower healing and more painful.)
DAY AFTER SURGERY:
- Begin brushing your teeth the day after surgery. It is important to brush all your teeth, even if the teeth and gums are sensitive. Bacterial plaque and food accumulation near the extraction site(s) will delay healing. Begin saltwater rinses the day after surgery – dissolve ½ teaspoon of salt in an 8-ounce glass of warm water. Gently rinse mouth for 1 minute, taking care not to suck or spit, but to have water fall from your mouth. Rinse mouth 4 times daily for as long as there is swelling and soreness – usually one week. In addition, you will want to begin rinsing with Peridex oral rinse, if prescribed.
- Warm soft foods may be eaten. Concentrate on adding protein to your diet (eggs, soft meats such as fish and poultry, tofu, pasta, beans, etc.). Avoid the operative site(s) when eating.
- Continue taking prescriptions, as directed.
DAY 3 AND BEYOND:
- Swelling and stiffness of the muscles peaks 2-3 days after surgery. Beginning 72 hours after surgery, you should apply a heat compress (heating pad/ warm washcloth) to the outside of your face for resolution of cheek swelling, muscle soreness, and bruising.
- If dissolvable sutures were used, they will begin to fall out 7-10 days after surgery.
- Continue taking prescriptions, as directed.
DAY 5 AND BEYOND:
- If you have been given an irrigating syringe, start irrigation 5 days following surgery. Prepare a salt water solution as described above. Fill the syringe with warm salt water and place the tip of the syringe directly into the extraction socket(s) to clean. Irrigate gently with the entire syringe of fluid. Do this 2 times a day until the extraction sockets gradually fill and you can no longer access them as the surgical site(s) heal. Typical syringe use goes beyond several (4-6) weeks. If you appreciate an increase of swelling, pain, or a foul fluid in the sockets (infection or pus), please notify our office. If any unusual bleeding or swelling occurs, please call our office.