After Wisdom Tooth Removal

Sometimes the after-effects of oral surgery are quite minimal, so not all of the instructions may apply in your particular situation.  Common sense will often dictate what you should do.  However, when in doubt follow these guidelines or call our office for clarification.  Our number is (435) 287-4455

BLEEDING: Bite down firmly on the gauze packs that have been placed over the surgical areas. Be sure they remain in place. Do not change them for the first hour unless the bleeding is not controlled.  The packs may be gently removed after one hour.  If active bleeding persists, place enough new gauze to obtain pressure over the surgical site for another 30 minutes.  Change gauze as necessary but only when active bleeding is present. Intermittent bleeding or oozing overnight is normal.  Bleeding may be controlled by placing fresh gauze over the areas and biting on the gauze for 30-45 minutes.  Severe bleeding is extremely rare.  If bleeding persists, it usually means that the packs are not positioned correctly. Try repositioning the packs directly over surgical sites.  If bleeding persists or becomes heavy, you may substitute a black tea bag for 30 to 40 minutes.  If bleeding remains uncontrolled, please call our office. Later in your healing it is normal to have red spit in your mouth off and on for several days after the surgery. This is not a problem and does not require treatment.

SWELLING:  Swelling is commonly associated with oral surgery.  It can be minimized by using a cold pack, ice bag or a bag of frozen peas wrapped in a towel and held adjacent to the surgical site.  This should be rotated side to side every 20 to 30 minutes for the first 24 to 48 hours after surgery. Keeping your upper body elevated above 30 degrees, even at night, for a few days will also help minimize swelling. The first two to three days after surgery are generally the most uncomfortable with the most swelling, bruising and jaw stiffness.  These symptoms usually peak in 48 to 72 hours after surgery then gradually improve thereafter. After the third day, the post-operative course should be gradual, steady improvement. After day 3, a warm compress to the area of swelling (hot water bottle, hot moist towels, heating pad) for 30 minutes will help decrease swelling and stiffness.

PAIN:  Most oral surgery is accompanied by some degree of discomfort. You will usually have a prescription for pain medication.  If you take the first pill before the anesthetic has worn off, you should be able to manage any discomfort better.  Take the pain medicines as directed by Dr. Barton. Precede each pain pill with a small amount of food.  If you anticipate needing more narcotic containing prescription medication for the night or weekend, you must call for a refill during normal business hours. 

NAUSEA:  Nausea may occur after surgery, but is generally short lived. If you have nausea and/or vomiting following surgery, sipping small amounts of regular Coke or ginger ale from a glass filled with ice will frequently settle your stomach. Sip a small amount (1/4 cup) slowly over a 15 to 30-minute period. If you tolerate this, then double the amount over the next 15 to 30 minutes. When the nausea subsides, you can begin taking solid foods and the prescribed medicine. Sometimes pain medications are the cause of nausea.  Nausea can be reduced by preceding each pain pill with a small amount of soft food, and taking the pill with a large volume of water, and decreasing your dose of pain medication. If you do not feel better, please call us.

DIET:  Eat any nourishing food that can be taken with comfort.  Avoid extremely hot foods.  Do not use a straw for the first few days after surgery.  It is best, to confine the first day’s intake to liquids or pureed foods (soups, puddings, yogurt, milk shakes, etc.).  Over the next several days you may gradually progress to solid foods.  If you take nourishment regularly you will feel better, gain strength, have less discomfort and heal faster.  If you are a diabetic, maintain your normal eating habits or follow instructions given by your doctor. DO NOT EAT foods like nuts, seeds, popcorn, etc., which may get lodged in the socket areas until they have closed completely, as they are more difficult to remove.

Oral Hygiene: Keeping your mouth clean after surgery is essential.  Use 1/4 teaspoon of salt dissolved in an 8-ounce glass of warm water and gently rinse.  Repeat as often as you like, but at least two or three times daily. Begin brushing your teeth the day after surgery.  Soreness and swelling may prohibit normal brushing, but please make every effort to clean your teeth within the bounds of comfort.

ANTIBIOTICS: Antibiotics are not routinely used after the removal of teeth. If you have been prescribed antibiotics, take them as directed. If you develop a rash or other reaction, stop the antibiotic and call us.

OTHER THINGS TO REMEMBER

HEALING:  Normal healing after tooth extraction is gradual. The first two to three days after surgery are generally the most uncomfortable followed afterward by gradual, steady improvement. Holes in the area where the teeth were removed may be rinsed with the plastic irrigating syringe AFTER 5 to 7 days.  Use it to irrigate the holes after meals and before going to bed. Keep using it until you no longer catch food in the sockets. The holes will completely heal on their own gradually.

EXERCISE CARE:  Do not disturb the surgical area today.  Do NOT rinse vigorously or probe the area with anything.  PLEASE DO NOT SMOKE for at least 5 days, since this is very detrimental to healing and may cause a dry socket.  Rest and keep your upper body elevated greater than 30 degrees, even when sleeping at night.  Avoid vigorous activity.

SHARP EDGES:  If you feel something hard or sharp edges in the surgical areas, it is likely you are feeling the bony walls which once supported the extracted teeth. Occasionally small slivers of bone may work themselves out during the following week or so.

Numbness of the lip, chin, or tongue is normal and is usually temporary in nature. Be careful to not bite the numb areas. If numbness persists after a day, don’t be concerned, but please let us know.

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.

Light headedness can occur after surgery due to dehydration or pain medication use. Standing up suddenly could cause you to be unstable. Before standing up, you should sit for one minute then get up.

If the corners of your mouth are stretched, they may dry out and crack. Your lips should be kept moist with the lip balm given or an ointment such as Vaseline.

It is our desire that your recovery be as smooth and pleasant as possible. Following these instructions should help your recovery go as comfortably as possible. You are an individual and no two mouths are alike. If you have concerns about your progress, do not accept well intended advice from friends or information you found online. Discuss your problem with the persons best able to effectively help you: please call us at (435) 287-4455. If you have concerns after hours, then call Dr. Barton’s cell phone at (406) 599-1901.