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 and these instructions should be followed carefully as it helps to prevent unnecessary pain and complications such as infection and swelling.

The day of SUrgery

• A responsible adult must be with you for the first 24 hours after surgery.
• We recommend getting a milkshake on your way home so you can take you pain medications before the numbness wears off. Do not use a straw, use a spoon.
• Eat every time before taking your medications to prevent nausea and vomiting.
• Avoid hot food while you are numb. Eating hot foods can burn your mouth without you knowing it. We suggest cool, soft foods.
• Do not drive or operate equipment for 24 hours after surgery.
• Do not drive while taking pain medications.
• Do not rinse your mouth out the day of the surgery, or brush your teeth.

The day after Surgery

• Start your antibiotics.
• Start rinsing with a gentle warm salt water mix.
• Continue with after surgery care – It is rare that additional aid is required if the instructions below are followed.
• Call (928) 773-2530 to make a follow up appointment so we can ensure your quick recovery. Please note that calling the office before 4pm allows us to better meet your needs.

Additional questions or concerns

If you have any additional questions or concerns please call our office during business hours at (928) 773-2530. If you suspect dry socket or other surgical related issues call us immediately. If the patient is in severe discomfort there is a staff member on call who is available after normal business hours.Your comfort is important to us.

Proper care following Oral Surgery will greatly help your recovery as well as help to prevent complications.

• Bite Firmly – Bite firmly on gauze to keep pressure over the surgery site for 30 minutes, until bleeding stops or per other instructions. Small amounts of blood is normal, there may be the appearance of more blood due to blood mixing with saliva. If you are saturating gauze with dark red blood every 20 minutes please call our office (928) 773-2530.
• Apply Ice – Apply ice to the face in the area of the operation for 6 hours, removing it for about 20 minutes after 20 minutes of application. Be careful of over icing your skin while you are numb as there is risk of getting frost bite on your skin. You may continue to do this for 2-3 days after, or longer as your comfort dictates.
• Hydrate – Liquids are important for recovery, drink water to stay hydrated. DO not drink carbonated, caffeinated, acidic, or alcoholic beverages. Do not drink hot liquids, especially while numb, to avoid burning your mouth without knowing it.
• Eat a Soft Diet – Cool, soft foods are best for the day of surgery. We recommend soft foods for the first 2-3 days after the surgery. Soft foods may be eaten up to a week if chewing is causing discomfort. Avoid foods that are hot, spicy, or contain any small seeds or grains.
• Sit up – Keep your head elevated. When in bed, use several pillows to prop up the head, especially the day of the surgery.
• Rinse – Use a warm salt water mix starting the day after surgery (1/4 teaspoon salt dissolved in a glass of warm water). Continue to do this until your post-operative appointment. Do not vigorously spit out the water, instead allow the salt water to fall out of your mouth into a sink. You may resume brushing your teeth as usual the day after the surgery, avoiding the surgical area until healed.
• Do Not – Suck or spit for 10 days, including using straws. Either of these motions can dislodge healing blood clots and lead to dry socket. A dry socket is painful and should is occur, you will need to be treated by the Doctor.
• Do Not – Drink Alcoholic beverages for 7-10 days after surgery or while taking pain medications.
• Do Not – Engage in strenuous activity for 7-10 days following surgery.
• Do Not – Smoke for 2 weeks following surgery. Smoking inhibits healing and the action associated with smoking can pull the clot out of the extraction sit and cause dry socket.
• Do Not – Drive while taking narcotic pain medications.

Dry Socket – Starting or increasing pain 4-6 days after the surgery may indicate dry socket. Dry socket is cause by premature loss of the blood clot. If you have these symptoms call the office immediately. It may be necessary to arrange for the placement of a medicated pack in the socket to relieve discomfort and assist healing.

Smoking significantly increases the chances of dry socket and delays healing.

Bleeding – Some bleeding following any tooth extraction is normal; bleeding may persist slowly for several hours and into the next morning. If bleeding continues after the removal of the first gauze, fold new gauze into a pad and insert over the site. Apply direct pressure over the socket by biting down for 30 minutes intervals. Keep your head elevated, you may want to use a towel over your pillow to prevent stains. In the case of sever, dark red, uncontrolled bleeding, call our office immediately (928) 773-2530.

Swelling – Swelling is a normal reaction by the body’s healing mechanism. Swelling usually reaches its peak around day 3-4 after surgery and slowly subsides. You may be swollen for up to 4-7 days after surgery. If you develop prolonged, hard, reddish swelling, accompanies by a fever of 101 degrees. Call our office (928) 773-2530.

Pain – Depending on the extant of the surgery some pain is expected. The medications prescribed to you should control the pain, it may take several hours for oral medications to reach their full effectiveness, we recommend you take the pain medications before the local anesthetic wears off. It is important that you follow the dosage directions on the bottle, medications taken in excess or on an empty stomach may cause nausea or vomiting.

• Pain typically peaks on day 3-4 after surgery.
• 1 tablet/capsule Tylenol (Regular strength) taken in conjunction with 1 tablet/capsule Ibuprofen (regular strength) is an effective method for reducing pain. Tae these medications according to package instructions. Do not take these medications while taking the prescribed narcotic. Do not take these medications if you are allergic to them.
• Do not take Ibuprofen with Naproxen.
• Do not take Tylenol with prescription Tylenol (narcotics can be Tylenol based).

Dizziness or Nausea – Dizziness or Nausea can be a side effect of the pain control medications, because of this, you must eat every time you take your medications and prior to taking your medications. Nausea is not a cause for alarm, it is not an allergic reaction. If you are experiencing nausea, slow the frequency of dosages. In the case of severe vomiting, discontinue the pain medication and call the office (928) 773-2530.

Allergies – -If you develop a rash it may be an allergic reaction to the drugs. Stop taking the medications immediately and call our office (928) 773-2530.

If you experience constricted breathing call 911 immediately.

The Following May be Expected After Surgery

• Discoloration of the skin next to the surgery site.
• A slightly elevated temperature during the first 24-48 hours.
• A slight odor or grayish covering over the surgery site that may last up to 10 -14 days.
• During the healing process, small fragments of bone may loosen up through the gums. These are not roots, and often work themselves out. If they remain stuck in the gum line, call the office for an appointment at (928) 773-2530.
• Sutures can take up to 2 weeks to fall out. Sutures may fall out before the anticipated time. If sutures fall out, it is not an emergency, no action is necessary.

Suggested foods

Day of Surgery – Pudding, yogurt, applesauce, ice cream, protein shakes, smoothies (no fruits with small seeds such as raspberries, strawberries, or blackberries). Drink water to stay hydrated.

Day after surgery – A soft diet is recommended i.e. mashed potatoes, macaroni and cheese, soups, stew, scrambled eggs, and the above listed foods. Stay away from hot foods to avoid burning your mouth.

AVOID – Anything temperature hot, spicy hot, crunchy, sharp, or acidic (such as tomatoes and tomato based foods, and citric fruits). Avoid small seeds and grains (Strawberries, chia seeds, flax seeds, rice, etc.) as they can get stuck in the extraction site and delay healing.

Other Complications

• If numbness of the lip, chin, or tongue occurs there is no cause for alarm. As reviewed in your consultation, 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. Call Dr. Dingman if you have any questions.
• 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. You could get light headed from low blood sugar or medications. Before standing up, you should sit for one minute before getting 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. Dingman.
• 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

There will be a void where the tooth was removed. The void will fill in with new tissue gradually over the next month. In the meantime, the area should be kept clean, especially after meals, with salt water rinses or a toothbrush.

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

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.