After Wisdom Tooth Removal

The removal of impacted teeth is a surgical procedure. Post-operative care is probably more important than the surgery itself. 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 place for the first hour or until you are ready to have something to eat. After this time, the gauze is removed and only replaced if the oozing continues.  Typically with firm pressure will reduce and stop the bleeding  Please avoid talking if the  is in place.
  • 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 before you feel discomfort.
  • Restrict your activities the first week after surgery and resume normal activity after your post-op appointment with Dr. Massoomi.
  • During the first 2 days, apply the provided compression dressing with re-freezable gel-packs to each side of your face. This will reduce the swelling that typically appears on the 3rd day.

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 applying pressure with a gauze over the surgical site.  Repeat if necessary. 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

The swelling that is normally expected is usually proportional to the surgery involved. Swelling and bruising 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 the 3rd – 5th day post-operatively. However, the swelling may be minimized by the immediate use of ice packs. After 48 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.

Pain

Pain control can be achieved by pre-treating the pain.  Please take the prescribed pain medications before the numbness from the local anesthesia wears off.

Some narcotic pain medications will make you groggy and will slow down your reflexes. Do not drive an automobile or work around machinery while taking these types of medications. 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 the office.

Diet

We usually recommend a non-chewing, soft-diet the first week.  Do not use straws as this may disrupt the blood clot that may be forming at the surgery site.  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

Maintaining excellent oral hygiene will only help to expedite your healing.  Please brush the rest of your teeth, starting on the day of the surgery.  Avoid the surgical site with the toothbrush, finger or tongue.  Use the prescribed mouthwash or salt water to rinse at least 5-6 times a day, especially after eating.

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. Always finish the course of antibiotics, unless you start to have side-effects such as diarrhea.  In such case you need to call the office.  Antibiotics may be given to help prevent infection. Obviously, discontinue antibiotic use in the event of a rash or other unfavorable reaction. Call the office to inform Dr. Massoomi.

Nausea and 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 of clear carbonate beverages, such as sprite or ginger ale.  Go slow. 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 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. Massoomi if you have any questions.
  • Slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, (3 hours >101.5) 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 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. Massoomi.
  • 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 (Trismus) of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a normal post-operative event which will resolve in time.

Finally

Sutures are placed the area of surgery to minimize post-operative bleeding and to help healing. Sometimes they become dislodged, this is no cause for alarm. 95% of the time self-dissolving sutures are used.

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. Massoomi.

Brushing your teeth is okay – avoid 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 4-5 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 immediately.