WISDOM TEETH 

Wisdom teeth removed? What to expect...
Home Care instructions: After extraction of wisdom teeth.

 

The removal of impacted wisdom teeth is an involved surgical procedure. The nature of your post operative course depends highly on your diligence with post operative home care.  Unnecessary pain and complications such as infection,  swelling, dry socket etc. can be minimized if the following instructions are followed carefully.

 

IMMEDIATELY FOLLOWING SURGERY

 

  • The gauze pad placed over the surgical area should be kept in place for 30 mins.   After this time, the gauze pad should be removed and discarded.  If oozing continues, replace the gauze with additional gauze provided in your take home bag. Bite on the new gauze for an additional 30 mins.

  • Avoid spitting, excessive rinsing or touching the surgical area. This may initiate bleeding by causing the blood clot that has formed to become dislodged, or transfer microscopic bacteria from your fingers into the surgical site.

  • 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 up for one minute before standing.

BLEEDING

 

Some bleeding or oozing from the site is normal for the first 24 hours. This can frequently be controlled by biting with pressure on a gauze pad placed directly on the bleeding wound for 30 minutes. If you run our of sterile gauze packs you may bite on a moist tea bag instead of it.  If bleeding continues, do call for further instructions.

 

SWELLING

 

Swelling is a normal response of your body to surgery. This swelling usually gets worse during the first 24-48 hours before it starts to resolve.  If you have had all four wisdom teeth removed, it is not unusual to see some swelling on your cheeks, around the lower eyelid and on the sides of your face. To minimize swelling apply the ice pack provided to you in your take home bag for 20 mins on,20 mins off for the first 24 hours.  You may reuse the ice pack by washing it  and refreezing it again.  An alternative to the ice pack is a frozen bag of peas.

NOTE:  If you experience any difficulty breathing or swallowing please call the office immediately for further instructions.

 

DIET

After general anesthetic or IV sedation only liquids should be consumed for the first few hours to avoid excessive nausea or vomiting.  After this only consume soft food and liquids on the day of surgery.  Return to a normal diet as soon as possible unless otherwise directed.  Good nutrition and hydration is very important for a speedy recovery.  Drink from a glass and do not use straws.  You may eat soft food by chewing away from the surgical sites. A high calorie, high protein intake is recommended.   Avoid alcohol, sugary drinks, hot liquids or hard foods.

  

PAIN
 
Pain and soreness after the procedure starts when the local anesthetic starts to ear off. This is usually takes about 2 hours.  You should begin taking your pain medication before the local anesthetic wears off so that you give the medication sufficient time to work.  This will enable you to experience very little or no pain during your post operative course.  Your prescriptions for pain control are highly regulated and are dispensed based on your individual needs, medical history and the discretion of your doctor.  Kindly, follow all the instructions given to you by your doctor/pharmacist or member of ROMS regarding these medications.  Also, kindly keep these medications in a safe place and out of the reach of children.  This is for the safety of you and your family.

NOTE: Avoid alcohol while you are on pain medication.

 

ORAL HYGIENE

 

A clean mouth will help you feel more comfortable and will aid in faster healing.  Rinse your mouth thoroughly after each meal, beginning the day after surgery.  Brush your teeth normally if possible.  Rinse with warm salt water (1 teaspoon of salt in a cup of warm water) 4-6 times a day. Use the syringe provided in your take home bag to remove food debris by filling it with warm salt water and squirting it gently into the extraction sites. This is performed in addition to the salt water rinses 2-3 times daily for 1 week.  Continue this  until healing is complete.  Please avoid using alcohol based mouth washes as these may be associated with a burning sensation in the delicate healing oral mucosa.

ACTIVITY

 

Limit vigorous exercise immediately following surgery.  If you exercise, throbbing or bleeding may occur. Surgery might reduce your normal nutritional intake and hence your capacity to exercise.  You might get dizzy or light headed if you exercise too soon after surgery.  You may start working out a week after surgery.  Do ask your doctor if you have any questions about this.

DISCOLORATION

 

In some cases, discoloration of the skin follows swelling. The development of black, blue, green, or yellow discoloration is due to metabolism of blood and inflammatory products formed during surgery and the healing process. This is a normal post-operative occurrence, which may occur 2-3 days after surgery.  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. Antibiotics help prevent or treat infections. Discontinue the antibiotic if you develop a rash or any other unfavorable reaction and contact our office immediately.  Call the office if you have any questions.

Nausea/Vomiting

Occasionally nausea and/or vomiting may occur following surgery.  Do not take anything by mouth for at least an hour, including the prescribed medicine, should this happen. Sip on coke, or ginger ale slowly.   When the nausea subsides you can begin taking solid foods and the prescribed medicine.

 
OTHER COMMON  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 on it and not feel the sensation. Call us if you have any questions.

  • Slight elevation of temperature immediately following surgery is not uncommon. If the elevated 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, 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 us.

  • If the corners of your mouth are stretched, they may dry out and crack. Your lips should be kept moist with any lip balm.

  • Sore throat and pain while swallowing are also common after surgery. This will subside in 2-3 days.

  • Stiffness (Trismus) of the jaw muscles may also 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 in the area of surgery to minimize post-operative bleeding and to help healing. Sometimes they become dislodged. This is no cause for alarm.  Just remove the suture from your mouth and discard it. The sutures will fall out approximately one-two weeks after surgery. The removal of sutures at the office requires no anesthesia or needles. It takes only a minute or so, and there is usually 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 our office for instructions.

 

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

 

Your case is unique, and no two individuals are alike. Discuss any problems with the trained experts best able to effectively help you: ROMS 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 near the ear may occur 2-3 days following surgery. Call the office if this occurs.