After Wisdom Tooth Removal Surgery
Wisdom teeth removal is a serious surgical procedure, and post-operative care is very important. Carefully follow these instructions to avoid unnecessary pain, infection, swelling, and other complications.
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Important 5-Steps Immediately After Wisdom Teeth Removal
Immediately following your wisdom teeth procedure, the surgeon and/or staff provide written post-operative instructions. The most important thing is to allow a blood clot to form over the surgical area. To ensure a healthy recovery and the success of your procedure, follow these 5 instructions:
1. Keep the gauze pad over the surgical area for a half hour (30 min). After you remove the pad, discard or throw it away.
2. Do not vigorously rinse with mouth wash or touch the surgical area. You must refrain from doing anything to dislodge the forming blood clot.
3. The local anesthetic will be wearing off. Take the prescription pain medication at the first sign of discomfort.
4. Do not engage in any physically exerting activities and take it easy for the rest of the day.
5. Manage swelling by keeping your head elevated as well as applying ice packs to your face. See the section on swelling for more information.
Day-By-Day Instructions After Wisdom Teeth Surgery
Successfully recovering from a wisdom tooth procedure has a lot to do with postoperative care. In the days following your wisdom tooth extraction, it is vital for you to follow the instructions provided by your surgeon to avoid complications.
Day 1: Day of Surgery
Today is a liquid diet day, since you don’t want to put pressure on the newly-formed clot.
Immediately after release from your procedure, the best thing to eat is a smoothie. But remember not to use a straw! Sucking through a straw can dislodge the clot and cause painful complications, like a “dry socket.”
It is important to have some food in your stomach before taking the prescribed pain medication and antibiotics. And a cold smoothie feels good against gums and helps to ease swelling.
Your body needs nutrients to heal, so have a variety of soft foods on hand. A few good ideas include…
• Cool broth
Ice cream, milkshakes, and other high-sugar soft foods are alright to eat. But, keep in mind that your body will recover faster and stronger if you stick to nutritious options.
Replace your gauze pad every 30 minutes and avoid disturbing the surgical area. Do not touch the area and avoid talking. When eating or drinking, remove the gauze from your mouth, and replace it with new one when you finish.
The gauze will show blood each time you remove the pad. When the bleeding appears to have stopped, you can stop using gauze. Bleeding usually stops within a few hours after surgery.
If bleeding doesn’t stop, it indicates that the blood clot has not yet formed within the tooth socket. Do not rinse, brush, or touch the area with your finger or tongue. And if bleeding persists after a few hours, use a moist tea bag in place of the gauze.
Stay ahead of the pain by taking 600mg Ibuprofen every 6 hours. Take Ibuprofen whether you feel the need or not. In between doses of Ibuprofen, if the pain is not controlled, you can take the prescribed narcotic pain medication.
Ibuprofen is safe to take with the narcotic pain medication your surgeon may prescribe. Tylenol is NOT SAFE to take with prescription narcotic pain medication since it already contains Tylenol (Acetaminophen) in it.
Swelling is manageable by using ice packs on the affected area of your face. Apply the ice pack for 30 minutes on, and 30 minutes off. Put the ice pack back into the freezer during the 30-minutes-off interval.
Day 2: 1st Day After Surgery
On the first day following your wisdom teeth removal, follow the same instructions as for Day 1 – with a few exceptions:
Add Soft Foods
On day 2 you can add some soft foods to the liquid diet. Some good ideas include…
• Mashed potatoes
• Blended soups
• Soft pasta
• Scrambled eggs
Use a soft-bristle toothbrush to gently brush the area AROUND the surgical site. Do not brush directly over the surgical area to avoid dislodging the blood clot. And do not spit – let the liquid fall out of your mouth and into the sink.
Days 3 to 6
Over the next 3 to 6 days of recovery, you can continue eating a soft food diet, as well as begin adding more substantial foods. Only eat what feels tolerable and do not push yourself. Swelling will be at its greatest on the third and fourth days.
After the second day of recovery, you can stop using ice packs, and swap using warm pads for the same 30-minute on/off intervals. And, over the next few days, you will clean the extraction area with a syringe and prescription mouth rinse. Warm salt water is also good for gently rinsing the surgical area.
Some bleeding is expected following your surgery. Do not be alarmed if you experience slight bleeding, oozing, or redness in your saliva. Excessive bleeding can be managed with the gauze pad.
If you experience excessive bleeding, rinse and wipe any old clots from your mouth. Then, place a fresh gauze pad over the surgical area, and bite down firmly for 30 minutes. Repeat this process a few times.
Use a Tea Bag if Bleeding Continues
If you continue to experience excessive bleeding, swap the gauze for a teabag. Black tea contains tannins that contract the blood vessels to help form a clot. Bite on a moistened black tea bag for 30 minutes.
To reduce bleeding, it is important to avoid strenuous activity, sit upright, and try to stay calm. If bleeding remains excessive, call our office for further instructions.
Following surgery, it is common to experience some swelling around the surgical area. Wisdom teeth removal surgery often produces slight swelling around the mouth, cheeks, eyes, and sides of the face. Swelling can become apparent the day after surgery and peeks at about 2 to 3 days post-operative.
Use Ice Packs for 36-hours After Surgery
The best way to limit the amount of swelling you experience is by using ice packs. Either two ice packs or two ice-filled Ziplock baggies will do the trick. The ice is applied directly to the sides of the face where surgery was performed.
During the first 36 hours following your surgery, use ice packs continuously while awake. Keep the ice on your face for 30 minutes, then remove it for 30 minutes – and repeat.
After the first 36 hours, ice no longer helps to reduce swelling. Instead, a moist warm cloth is better for treating the swelling.
Following surgery, the local anesthetic is still making its way out of your system. You want to be ready to take the Ibuprofen pain medication before it completely wears off. Your surgeon will give you specific instructions regarding your pain treatment options.
Managing Moderate Pain
Moderate pain can be effectively managed with Tylenol, Extra Strength Tylenol, or Ibuprofen (Advil or Motrin). Do not take any medication to which you are allergic. Talk to your surgeon about any allergies or aversions you may have to pain medication.
Tylenol, Extra Strength Tylenol, or Ibuprofen
Take the prescribed Ibuprofen every 6 hours for the first 2-3 days. If you are using OTC, take one or two tablets of Tylenol or Extra Strength Tylenol every 3 to 4 hours. Advil and Motrin contain Ibuprofen and may be taken instead of Tylenol. Over the counter, Ibuprofen usually comes in 200mg tablets.
You can take 2 to 3 tablets of 200mg Ibuprofen 4 times per day (not to exceed 3200mg in 24-hours). Alternate the Tylenol and Ibuprofen every 2 hours if needed.
Severe Pain Management
Your surgeon may give you prescription narcotic pain medication for severe pain management. Only take the prescription pain medication as instructed by your surgeon, and follow all precautions listed on the medication. And never mix your prescription narcotic pain medication with any over-the-counter Tylenol, unless otherwise advised by your doctor.
After swelling peaks on days 2 or 3 following surgery, pain should subside. If severe pain persists, call our office. While on prescription pain medication you should not drive or operate heavy machinery and avoid alcoholic beverages.
Only consume liquids following your general anesthetic or IV sedation. When drinking, DO NOT use a straw, and DO NOT smoke for the duration of your recovery. The sucking motion of using a straw or smoking a cigarette can dislodge the blood clot forming in the surgical extraction area.
Since, your solid food is limited in the first few days following surgery, compensate with plenty of fluids. Aim for drinking at least 3 liters of water per day and try not to miss meals. High-protein intake and lots of clear fluids will help you recover faster and have less pain in the process.
Beginning the day after surgery, you can eat soft foods as long as you chew away from the surgical area. For a quick and strong recovery, your body needs a high-calorie diet with lots of protein. Contact our office for a complete list of dietary suggestions for patients recovering from wisdom tooth surgery.
Keeping Your Mouth Clean
DO NOT perform rinsing of any kind until the day after surgery. On the day after your surgery, you can begin rinsing your mouth 5 or 6 times per day. This is especially important after eating.
Fill a cup with warm water – not hot water. Then, mix a teaspoon of table salt into the water. Use this mixture to gently rinse your mouth, and let the liquid fall out of your mouth into the sink.
Do not be alarmed by the appearance of discoloration of the skin. Black, blue, green, or yellow discoloration can sometimes follow swelling.
Discoloration usually occurs 2 to 3 days postoperatively. Using a warm moist cloth on the affected areas can help to reduce the swelling and discoloration.
You may be prescribed antibiotics to help prevent infection following your surgery. Take antibiotics as directed and finish the entire course of antibiotic treatment. Do not discontinue taking your antibiotic treatment without calling our office and speaking with us directly.
Nausea and Vomiting
If you experience nausea and/or vomiting after your surgery, avoid taking anything by mouth for at least an hour. This includes your pain medication. Over 15 minutes, slowly sip on a Coke, tea, or ginger ale to help settle your stomach.
• 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. Berley, Dr. Torres, or Dr. Berenstein 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 lightheaded from low blood sugar or medications. Before standing up, you should sit for one minute.
• Occasionally, patients may feel hard projections in the mouth with their tongue. They are not roots; they are the bony walls that supported the tooth. These projections usually smooth out spontaneously. If not, they can be removed by one of our surgeons.
• 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 or lip balm.
• 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 that will resolve in time and can be helped with warm compresses and light stretching.
Sutures are placed in the area of surgery to minimize post-operative bleeding and to help to heal. Sometimes they become dislodged. This is no cause for alarm. Just remove the suture from your mouth and discard it. The sutures will be dissolved by approximately one week after surgery.
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 month. In the meantime, the area should be kept clean, especially after meals, with saltwater rinses or a toothbrush.
Your case is unique – no two mouths are alike. Discuss any problems with the trained experts best able to effectively help you: Drs. Berley, Torres, & Berenstein.
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.
If you are involved in regular exercise, be aware that your normal nourishment intake is reduced. Exercise may weaken you. If you get lightheaded, stop exercising. We recommend no exercise for 5 days after surgery, and nothing strenuous for the first week.
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