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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

  • You will leave the office with a gauze pad placed over the surgical area. This should be kept in place for one to two hours. After this time, the gauze pad should be removed and discarded. If bleeding persists the gauze pad should be replaced.
  • Avoid brushing, rinsing, spitting and touching of the wound area for the first 24 hours following surgery. This may initiate bleeding by causing the blood clot that has formed to become dislodged.
  • Do not drink through a straw for the first 48 hours.
  • Take pain medications prior to feeling discomfort. Then take medications for pain as indicated or advised by our office. Do not take pain medications on an empty stomach.
  • Restrict your activities the day of surgery and resume normal activity when you feel comfortable.
  • Ice packs may be applied to the sides of your face where surgery was performed for the first 24 hours only. Refer to the section on Swelling for an 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 which results in your mouth filling rapidly with blood may be controlled by wiping any old clots from your mouth, then placing a gauze pad over the area and biting firmly for one hour. Repeat if necessary. If bleeding continues, bite on a moistened tea bag for one hour. The tannic acid in the tea bag helps to form a clot by constricting bleeding vessels. To minimize further bleeding sit upright and avoid exercise. If bleeding does not subside, call 818 986-6787 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 may not become apparent until the day following surgery and will not reach its maximum until two to three days post-operatively. However, the swelling may be minimized by the immediate use of ice packs. A plastic bag filled with ice, or ice packs should be applied to the sides of the face where surgery was performed. The ice packs should be applied on and off for periods of 15-20 minutes. After 24 hours, do not apply any ice. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery.

Pain

You should begin taking pain medication before the local anesthetic wears off. For moderate pain, one or two over the counter tablets of Ibuprofen (Motrin or Advil) or Tylenol may be taken every three to four hours.

For severe pain, take the tablets prescribed as directed. The prescribed pain medicine may 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 begin to subside after the third or fourth day. If pain persists, it may require attention and you should call the office.

CAUTION: Do not take any of the above medications if you are allergic or have been instructed by your doctor not to take it.

Diet

Proper nourishment after surgery is desirable to promote healing. Stay on a soft diet for several days after your procedure. Avoid foods that are hot or spicy. Do not use straws when drinking 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 site(s). High calorie, high protein intake is very important. Try to maintain a normal diet. 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 five to six 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

Mouth cleanliness is essential to good healing. No rinsing of any kind should be performed until 24 hours following surgery. You can brush your teeth 24 hours after surgery but rinse gently. The day after surgery you should begin rinsing two to three times a day and after meals with a cup of water mixed with a teaspoon of salt. Continue this procedure until healing is complete.

REMEMBER: A clean wound heals better and faster.

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 postoperative occurrence, which may occur two to three days post-operatively.

Antibiotics

If you have been placed on antibiotics, take the tablets or liquid as directed. Discontinue antibiotic use in the event of a rash, diarrhea or other unfavorable reaction. Call the office if you develop any reaction to a prescribed medication.

Nausea & 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 a carbonated drink such as ginger ale or sprite. You should sip slowly over a 15-minute period. When the nausea subsides, you can begin taking solid foods. You may need to discontinue use of the prescribed medicine. Call the office at 818 986-6787 for instructions.

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 Dr Haim if you have any questions.
  • A slight elevation of temperature immediately following 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. Before standing up, you should sit for one minute and then get up.
  • Occasionally, patients may feel hard or sharp 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. Haim.
  • 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 two to three days.
  • Stiffness (trismus) of the jaw muscles may cause difficulty in opening your mouth and may persist for several weeks following surgery. This is a normal post-operative event that will resolve in time.

Finally

Sutures may be placed in the area of surgery to help healing. Sometimes they become dislodged.  This is no cause for alarm. Just remove the suture from your mouth and discard it. Oftentimes the sutures placed will dissolve on their own. If they need to be removed, they will be removed approximately one week after surgery. 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.

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 the office for instructions.

There will be a cavity where the tooth was removed. The cavity will gradually fill in with new tissue over the next month. In the meantime, the area should be kept clean especially after meals with salt-water rinses and a toothbrush. You may be given a syringe at your follow up appointment which can be used to gently irrigate the surgical areas.

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. Haim or your family dentist.

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

A dry socket is when the blood clot gets dislodged prematurely from the tooth socket. Symptoms of throbbing pain at the surgical site and even pain to the ear may occur three to four days following surgery. Call the 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. It is recommended that you avoid rigorous exercising for one week after surgery.