Proper post-operative care after surgery is very important to optimize the healing process and to reduce the complications of wisdom teeth removal.
Immediately Following Surgery
The gauze pack should be kept in place with firm pressure over the wisdom tooth extraction site. Remove the pack after 30 minutes. If there is continued excessive bleeding, replace with new gauze and bite firmly again. Vigorous mouth rinsing or chewing in the areas of the wisdom tooth extraction should be avoided. This may cause increased bleeding or the blood clot to dislodge.
A liquid or soft diet is recommended for the first 24 hours. After 24 hours, you may progress your diet gradually as your comfort level allows. Avoid sucking through straws and eating hard or crunchy foods and spicy foods. Take the prescribed pain medication before the numbness from the local anesthesia wears off.
Restrict your activities on the day of your wisdom tooth extraction surgery and return to normal activities slowly. Place ice packs on the outside of the face where the wisdom tooth extractions were performed. Use ice for the first 48 hours to decrease swelling by applying it as continuously as tolerable.
Slight bleeding and redness in the saliva are common after wisdom tooth removal. If there is excess bleeding, gently wipe any old clots from the mouth and then place clean new gauze over the area and bite firmly for 30–40 minutes. Repeat every 30–40 minutes with new gauze. If excessive bleeding continues, bite on a cold-water-moistened tea bag firmly for 30–40 minutes. Slowly remove the tea bag and leave the area alone. If there is continued excessive bleeding, call our office for further instructions. Also, avoid excessive talking, drinking from a straw, or excessive chewing if there is continued bleeding.
Swelling is normal after any surgical procedure, including wisdom tooth removals. The extent of swelling varies and depends on the extent of the surgery and each individual patient. Swelling around the mouth, jaws, cheeks, and below the eyes is not uncommon. The swelling will usually reach its maximum 2–3 days after the wisdom tooth extraction procedure. The swelling can be decreased by the immediate use of ice packs in the first 48 hours. Ice packs should be applied to the outside next to where the surgery was performed. Keep the ice on as continuously as tolerable. Also, sitting upright and not lying flat on the first day will help to decrease the amount of swelling. You may have been prescribed other anti-inflammatory medications, such as dexamethasone (Decadron®). If you were prescribed these medications, follow the instructions written on the bottle.
Pain medications are normally required after wisdom tooth extraction surgery. If you can take ibuprofen (Motrin® or Advil®), take 400–800 mg every 6–8 hours or as prescribed by your doctor. Ibuprofen will help with pain relief and swelling reduction as an anti-inflammatory. If you cannot take ibuprofen, then 1–2 tablets of acetaminophen (regular Tylenol®, 325–650 mg) should be taken every 4–6 hours. If you were prescribed a stronger pain medication such as Norco® (hydrocodone with acetaminophen), Tylenol® with codeine, or Percocet® (oxycodone with acetaminophen), you can take that in addition to your ibuprofen if the pain is severe, but do not combine Norco®, Tylenol® with codeine, or Percocet® with any medication containing acetaminophen (Tylenol®). Follow the directions written on your prescription bottle. If you do take any of these medications, do not drive or work around machinery. Also, avoid alcohol while taking these medications.
If you are uncertain how much pain medicine to take or how often, please call us.
If the pain is severe, not controlled with your medications, or persists, please call us.
Proper oral hygiene is important because it helps reduce chances of an infection. Very gentle rinsing should begin the day of wisdom tooth extraction surgery. If you were given a prescription for mouth rinse, follow the instructions on the prescription. If you were not given one, rinse gently with warm salt water twice daily. You can brush your teeth the day after your wisdom tooth extraction, but be careful not to traumatize the area where the surgery was performed.
If you had IV sedation or general anesthesia for your wisdom tooth extraction, liquids should be initially taken. Your diet can then progress to more solids as tolerated. Ensure adequate fluids and nutrition to prevent dehydration.
Nausea and Vomiting
After IV sedation or general anesthesia, some patients may feel nauseated and vomit. To help avoid this problem, do not take your medications on an empty stomach. Hold off on your medications if possible until nausea subsides. Try to stay hydrated with liquids. Sometimes patients feel nauseated from the prescribed pain medications, particularly the stronger pain medications such as hydrocodone or oxycodone (Norco® or Percocet®). Try stopping the pain medications and see if nausea subsides. If you have continued nausea and vomiting, call our office for further instructions.
Bruising and Discoloration
After surgery, some patients may notice bruising or discoloration around the areas of surgery. This is normal postoperatively and can take several days to subside.
Jaw Tightness or Limited Mouth Opening
This is normal following surgery and will improve and resolve over time. On occasion, you may be shown jaw exercises to help increase your jaw opening.
Dizziness or Lightheadedness
After IV sedation or general anesthesia for wisdom tooth removal, some patients may feel dizzy when standing up. Always have someone watching you the first 24 hours after sedation. Do not get up quickly from a sitting or lying position and make sure to remain hydrated with fluids.
Smoking can inhibit the healing process and can cause more pain after your wisdom tooth extraction surgery. To ensure the best post-operative recovery, refrain from smoking for as long as possible after your wisdom tooth or teeth removal procedure.
If you have any questions or concerns following your wisdom tooth extraction, please don’t hesitate to call our office. We are on call 24 hours a day.