DISCLAIMER – Please note these are generic postop instructions for wisdom teeth. Each patient and each case is different. You will be provided with your own, written postop instructions that is unique to your case. Please try to follow your own postop instructions. The instructions below are meant to provide a general overview of the postop instructions for wisdom teeth extractions.
The removal of impacted teeth is a surgical procedure. Post-operative care is probably more important than the surgery itself. Unnecessary complications can be minimized if the post-operative instructions are followed carefully.
IMMEDIATELY FOLLOWING SURGERY
- The gauze pad placed over the surgical sites should be kept in place for the first hour or until you are ready to have something to eat or drink. Prior to eating or drinking, always remove the gauze and only replace it if you see active bleeding/oozing. Firm pressure will reduce and stop most post-operative bleeding. Please try to minimize the talking while the gauze is in place, as this will reduce your ability to apply pressure to the extraction site. Most people will have some level of bleeding/oozing for the first few days.
- 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. Only soak the mouth with the prescription mouthwash, do not swish and spit with this mouth wash.
- Take the prescribed pain medications before your local anesthesia wears off. Dr. Massoomi will provide you with long-lasting local anesthesia during the surgery in order to prevent you from having pain after surgery and to also provide you and your ride enough time to pick up your prescriptions from the pharmacy.
- Restrict your physical activities the first week after surgery until after we see you back for your first postop appointment. Any increase in heart rate and blood pressure can cause additional bleeding, bruising and swelling after surgery. Only resume normal activity after your post-op appointment with Dr. Massoomi. He will tell you what type of activity is okay to resume at that point.
- During the first 2-3 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.
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, try to avoid any activity that can increase your heart rate and blood pressure. If bleeding does not subside after you apply pressure for one hour, call our office for further instructions.
The swelling that is normally expected is usually proportional to the surgery involved. The more drilling to remove impacted third molars, the more the swelling. Swelling and bruising around the mouth, cheeks, eyes and sides of the face is not uncommon. This is the body’s natural defense mechanism, a 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 for the first 2-3 days. Due to the swelling the jaw will stiffen and you will notice that it is a little more difficult to fully open your mouth. This stiffness will persist for several days after surgery and there is no cause for alarm. This is a normal reaction to surgery and as the swelling subsides, the opening of the mouth will return to normal.
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 while taking any of the prescription medications, especially pain medications and antibiotics. Pain or discomfort following surgery should subside more and more every day. If pain persists, or worsens with time, it may require attention and you should call the office.
Foods to Eat After Wisdom Teeth Surgery
We usually recommend a non-chewing, liquid to soft-diet until we see you back for your 7-10 day postop appointment. Do not use straws as this may disrupt the blood clot that may be forming at the surgery site. The sucking motion can also cause more bleeding by dislodging the blood clot. Most patients stick to liquid diet for the first few days then work themselves up to a soft non-chewing diet. A diet that is nutritional and high in protein is very important for healing. Ideally you should eat something small before you take any medication, meaning that you will be snacking every few hours for the first few days as you take your prescribed medications. Nourishment and hydration with liquids should occur regularly in order to prevent dehydration. Because your food intake will be limited for the first few days, you should try to 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 nourish your body. Caution: If you are dehydrated, if you suddenly sit up or stand from a lying position you may become dizzy. This is the reason why it is recommended that you get up slowly from the lying position after surgery, make sure you sit for one minute before standing.
KEEP THE MOUTH CLEAN
Maintaining excellent oral hygiene will not only help to expedite your healing but also to prevent infections after surgery. On the day of surgery, you are encouraged to brush the rest of your teeth, while avoiding the surgical sites. Avoid the surgical site with the toothbrush, toothpik, floss, waterpik or anything that may disrupt the surgical site and sutures. Use the prescribed mouthwash or salt water to rinse at least 5-6 times a day, especially after eating. Removing the extra food debris will reduce the chance of infections by removing the source of nutrition for the bacteria that naturally live in our mouths…they feed on our food!
In some cases, discoloration of the skin can occur after surgery. 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 breakdown of the blood that is causing the discoloration, however this may also increase the swelling. Hence, it is our recommendation to allow nature to take its own course, unless you are very self-conscious about the bruising and would like to have it disappear sooner. Instead of applying the moist heat, some patients have used foundation makeup, to mask the bruising.
If you have been placed on antibiotics, please take the medication as directed. Always finish the course of antibiotics, unless you start to have side-effects, in which case it is best to call Dr. Massoomi. He will guide you as to what is the best course of action in your case. DO NOT STOP taking the antibiotics, withour notifying Dr. Massoomi. This can lead to serious complications. If in doubt about anything having to do with your surgery, just call the office. We are here to help you!
NAUSEA AND VOMITING
In most cases nausea and/or vomiting occurs on the day of surgery or may occur immediately after taking a mediation after taking a prescription medication, especially in an empty stomach. In the event that nausea and/or vomiting occurs after surgery, do not take anything by mouth for at least an hour including the prescribed medicine. Wait until your stomach settles down first, before trying to take in some clear liquids, such as gatoraid, gingerale or sprite. You should try to sip a small amount each time. Go slow. You should sip slowly over a fifteen-minute period. When the nausea subsides you can begin take soft foods again, along with your scheduled prescribed medications. In most cases Dr. Massoomi has already provided you with pre-operative anti-nausea medication through your IV during the surgery. You will also be provided with a prescription for anti-nausea medication for home that is typically a sublingual tablet that dissolves in the mouth. Please take this after surgery if you feel nauseated. This usually helps to prevent vomiting. If vomiting occurs, no worries as most patients feel better afterwards. Just make sure to clean your mouth afterwards with the prescribed mouthwash.
- 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 because of the local anesthesia. You should be aware that if your lip or tongue is numb, you could bite it and not feel the sensation. So be careful, this is why it is recommended to stay on a non-chewing diet and to avoid anything really hot in temperature as you amy burn yourself. This is especially in concern in children who need to be closely watched to make sure that they are not repeatedly chewing on their lips . Call Dr. Massoomi if you notice any issues.
- Slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, (3 hours >101.5) notify the office. Depending on how far out from the surgery you are, you may are already taking anti-fever medications such as Tylenol and/or ibuprofen. If not, please take any over-the-counter anti-fever medications such as Tylenol or ibuprofen
- 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 a few weeks after surgery, patients may feel hard projections in the lower jaw, all the way in the back next to their tongue. These are not roots or remnants of teeth, as assumed by most patients. These are actually a normal anatomical portion of the bony walls in the lower jaw that used to support the extracted tooth. These bony projections usually smooth out spontaneously and are best left alone. In some rare cases if these bony projections continue to stubbornly persist and bother the patients, they can be removed by Dr. Massoomi via a small surgical procedure.
- During the surgery, we have to use retractors to protect your lips, tongue and other vital structures. This can cause the corners of your mouth to be stretched, that may dry out and crack. You should try to keep your lips moist with any over-the-counter ointment.
- Sore throats and pain during swallowing is not uncommon, as the muscles in the throat can get swollen because of the surgery. The normal act of swallowing can then become painful but this should 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 as the swelling subsides.
Sutures are almost always placed the area of surgery to minimize post-operative bleeding and to help expedite the healing process. Sometimes they become dislodged, this is no cause for alarm. 95% of the time self-dissolving sutures are used.
Each surgical case is individual and unique. 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.