After Wisdom Tooth Removal

The removal of impacted teeth and wisdom 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 Oral Surgery

We ask that you bite on a gauze pad for 30-45 minutes after the surgery. If the bleeding or oozing still persists, place another gauze pad directly over the extraction site(s) and bite firmly for another 30-45 minutes. You may have to do this several times. You can leave the gauze out when there is light spotting or the gauze is pink when you remove it after 30-45 minutes.
Vigorous mouth rinsing or touching the wound area following oral 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 get home. We recommend that you take ibuprofen every 6 hours as long as you do not have an allergy to it. If you were prescribed a stronger prescription pain medication, you can take it in addition to the ibuprofen as needed or as instructed. Try to eat something, even a small amount or drink a glass of juice, when taking your medication to try to avoid it upsetting your stomach.
Restrict your activities the day of oral surgery and resume normal activity when you feel comfortable.
Place ice packs to the sides of your face where oral surgery was performed. Refer to the section on swelling for explanation.

Bleeding Following Oral Surgery

A certain amount of bleeding is to be expected following oral surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon. Excessive bleeding may be controlled by first 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, gently bite on a moistened black tea bag wrapped in gauze 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 our office for further instructions.

Swelling Following Oral Surgery

The swelling that is normally expected is usually proportional to the oral surgery involved. Swelling around the mouth, cheeks, eyes and sides of the face is not uncommon. This is the body’s normal reaction to oral surgery and eventual repair. The swelling will not become apparent until the day following oral 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 oral surgery was performed. The ice packs should be used for 20 minute intervals until bedtime of the first day. After 36 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 oral surgery. Thirty-six hours following oral surgery, the application of moist heat to the sides of the face is beneficial in reducing the size of the swelling.

Pain Following Oral Surgery

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 our Vernon Hills oral surgery office.

Diet Following Oral Surgery

After general anesthetic or I.V. sedation, liquids should be initially taken. Do not use straws for 12 hours after surgery. 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.

Keep the mouth clean

Try to avoid rinsing or spitting until the day following oral surgery. You can brush your teeth the night of oral surgery but rinse very gently. The day after oral 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 given an irrigating syringe to rinse the lower surgical sites, please use as directed after meals and before bed.

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. Not everyone receives antibiotics. It is prescribed on a case by case basis. Discontinue antibiotic use in the event of a rash or other unfavorable reaction. Call our office if you have any questions.

Nausea and Vomiting

In the event of nausea and/or vomiting following oral 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.

Other Complications

If numbness of the lip, chin, or tongue occurs there is no cause for alarm. As stated before oral 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 Dr. Brunetti if you have any questions.
Slight elevation of temperature immediately following oral surgery is not uncommon. If the temperature persists, notify the office. Tylenol or ibuprofen should be taken to reduce the fever.
You should be careful going from the lying down position to standing. You were not able to eat or drink prior to oral surgery. It was also difficult to take fluids. Taking pain medications can make you dizzy. You could get light headed when you stand up suddenly. Before standing up, you should sit for one minute then get 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. Brunetti.
If the corners of your mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment such as vaseline.
Sore throats and pain when swallowing are not uncommon. The muscles get swollen. 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 oral surgery. This is a normal post-operative event which will resolve in time.

Finally

Dissolvable sutures may have been placed the area of oral surgery. Sometimes they become dislodged, this is no cause for alarm. Just remove the suture from your mouth and discard it. If sutures were placed, they can be removed approximately one week after oral surgery if they have not fallen out on their own. The removal of sutures requires no anesthesia or needles. It takes only a minute or so, and there is no discomfort associated with this procedure. So its really nothing to worry about.

The pain and swelling should subside more and more each day following oral 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. Do not accept well intended advice from friends. Discuss your problem with the persons best able to effectively help you: Dr. Brunetti or your family dentist.

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 our office if this occurs.

If you are involved in regular exercise, be aware that your normal nourishment intake is reduced. Exercise may weaken you. If you get light headed, stop exercising.