After Wisdom Tooth Removal

Home Instructions After Wisdom Teeth Extraction

The removal of impacted wisdom teeth (third molars) is a serious surgical procedure. Postoperative care is very important. Unnecessary pain and complications such as infection and swelling can be minimized if these instructions are followed carefully.

Immediately Following Surgery

    • Vigorous mouth rinsing and spitting should be avoided until the morning after surgery. This may initiate bleeding by causing the blood clot that has formed to become dislodged.
    • Touching the wound area following surgery should be avoided until the morning after surgery.
    • Take the prescribed pain medications every 4 hours until the freezing is gone and then take pain medication as prescribed on the bottle.
    • Restrict your activities the day of surgery. You may resume normal activity when you feel comfortable.
    • Use ice packs to the sides of your face where surgery was performed for approximately 3 to 4 days.
    • Do not smoke or vape for at minimum 1 week.  
    • If you suddenly sit up or stand from a lying position, you may become dizzy. Following surgery, you may want to take it easy and go slow for the first 24 hours. 
    • Sutures are placed in the area of surgery to minimize postoperative bleeding and to help healing. They are resorbable in nature and should completely resorb, which can take up to 3 months. If a suture becomes dislodge, this is no cause for alarm, and you can remove it from your mouth and discard it. 

CONTROL OF POSTOPERATIVE BLEEDING

It is normal to bleed or ooze for some time following oral surgery. It is also not unusual to have blood on the pillow or in the saliva for three to four days after surgery. To control bleeding from the extraction socket, it is necessary to place the gauze directly over the surgical site and apply firm pressure. Change the gauze every 30 to 45 minutes until only pink staining or spotting is present on the gauze. At this point, the gauze is no longer required. To drink, eat, and sleep, remove the gauze from the area. If oozing continues or recurs, the following days, reapply gauze with firm pressure on the site until bleeding stops.

If you are having difficulty controlling the bleeding, or run out of gauze, you may purchase more gauze. Do not chew the gauze. A constant firm pressure is most effective in controlling the bleeding.

It is important to note that for wisdom teeth surgery, the gauze must be folded and placed directly behind the lost molar tooth. If it is not placed directly over the bleeding site, it may act as a wick and appear that you  are  bleeding significantly more than you are.

medications 

You may receive a prescription for pain medications, antibiotics (to prevent infection), anti-inflammatories, and an oral rinse. Please have the prescription filled at a pharmacy directly after leaving our facility.

Prior to leaving, you will receive your first dose of pain medication from the nurse. Continue to take the medication every 4 hours regularly until the freezing subsides. After the freezing subsides, take the pain medication as prescribed on the bottle. Follow the nurse’s instructions on the use of non-prescription and prescription medication. Anti-inflammatories should be taken in between doses of pain medication. Do not take more than one pain medication at a time. Antibiotics should be started on the day of surgery, within the first 2 to 4 hours following the extraction. The oral rinse should be started the day following surgery. Antibiotics, pain medications, and anti-inflammations should not be taken on an empty stomach as they may cause nausea and vomiting. Please take all medication with dairy/non-dairy products such as chocolate milk, high-fat milk, lactose-free milk, soymilk, yogurt, or ice cream. PLEASE DO NOT TAKE MEDICATION WITH WATER.  Always carefully read and follow the label directions and dosing instructions. 

If you have been placed on antibiotics, take the tablets or liquid as directed. Take your antibiotic prescription until the prescription is finished.

Do not drive an automobile or work around machinery. These medications will make you legally impaired.    

If there is any allergic reaction to any of the medications, stop all medications and contact our office. If the reaction is severe, please proceed to the nearest emergency department or call 911.

DIET

Following oral surgery, your body requires adequate fluids and nourishment. While your jaw is frozen, drink only liquids and soft foods (foods that require no chewing until freezing is gone) such as Jell-O, pudding, yogurt, applesauce, juices and pop. DO NOT USE A STRAW FOR ONE WEEK FOLLOWING SURGERY. You should drink two to four litres of liquids a day for the first few days following surgery. Avoid foods that break down into hard crunchy bits such as chips, popcorn, nachos, pretzels, whole grain or crusty bread, seeds, nuts, raw vegetables, fruits with seeds such as strawberries, raspberries and blackberries. These foods are easily lodged in the sockets and are very difficult to rinse out, and can cause an infection. Avoid these foods for 6 to 8 weeks. Gradually return to solid food and a normal diet.

Avoid foods that break down into hard crunchy bits, chips, popcorn, nachos, pretzels, whole grain or crusty breads, seeds, nuts and raw vegetables. These foods are easily lodged in the sockets, and are very difficult to rinse out, possibly causing an infection. Avoidance of these foods for 3-4 months is advised.

ORAL HYGIENE  

BRUSH AND FLOSS YOUR TEETH GENTLY: Take care when cleaning around the healing site(s). Make sure to keep your mouth clean. Starting the day after surgery, gently swish with Listerine Zero (or your prescribed mouth rinse) four times a day. You will need to rinse your mouth adequately to remove all food debris from the extraction sites, particularly the lower jaw. Using your Monoject™ Syringe that was provided, rinse your surgical sites with tap water or Listerine Zero after every time you eat or chew anything. If you have had your wisdom teeth removed, you must take care to direct the point of the syringe into the surgical sites, If there appears to be no holes where the teeth were extracted, you must direct the point of the syringe behind the last molar. It is important to rinse with the Monoject™ Syringe for a minimum of 8 weeks.

SWELLING/STIFFNESS/BRUISING

Swelling, stiffness and bruising can occur following minor surgical extractions. Swelling will be at its maximum on the third post-surgical day and will begin to disappear by the fourth or fifth day. A slight temperate for 2 to 3 days is normal. To minimize swelling, apply ice packs to the face constantly for the first 3 to 4 days following surgery. After the fourth day, switch to gently massaging the face with a warm cloth to continue to bring swelling down (cold will be ineffective at this point). Heat should be used for 15 to 20 minutes every hour you are awake. To avoid stiffness, make sure to include gentle movement of the jaw from left to right, forward and back, and opening and closing. Swelling should gradually decrease within 5 to 7 days but may persist longer.

If swelling increases after the fourth day post-surgery, this may be a sign of an infection. Please contact our office to determine whether it requires a followup appointment.

Bruising of the face and jaw following surgical extractions is normal. It may occur within the first 3 to 7 days and may appear dark purple or greenish-yellow in color. Bruising may also occur in the neck and upper chest area. Gently massaging for 15 minutes every hour with a warm cloth will aid in the healing.

ACTIVITY 

Avoid strenuous activity and physical activities for a few days after surgery as these activities increase your blood pressure and more bleeding will occur at the surgical site(s).

SMOKING/ALCOHOL

Smoking is discouraged for at least six weeks post-surgery. Smoke contains chemicals that can impair the healing process and blood supply. Smoking may lead to increased bleeding, a higher chance of post-operative infection, wound breakdown and the development of dry socket. Do not drink alcohol, use street drugs, cannabis, sedatives, or recreational drugs.

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. Robinson, Dr. Lung, Dr. Davis or Dr. Forrest if you have any questions or concerns.
  • Slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify our 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 Drs. Robinson, Lung, Davis or Forrest.
  • 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 postoperative event which will resolve in time. Jaw exercises, such as wide mouth opening  will help with this.