After Wisdom Tooth Removal
The removal of impacted teeth is a serious surgical procedure. Post-operative care is very important. Unnecessary pain and the complications of infection and swelling can be minimized if the instructions below are followed carefully.
A small amount of bleeding is normal. This is generally controlled by keeping steady pressure on the bleeding area by biting firmly on the gauze placed by the surgical assistant. Pressure helps reduce bleeding and assists the formation of the clot. Once home, gently remove gauze pad so you can eat and take your pain medication. If bleeding persists, place a fresh, folded gauze pad over the area and apply pressure by biting firmly for 30 minutes. If bleeding continues in spite of the above, moisten a tea bag in cold water and place bag over the area, biting firmly for 30 minutes. Lying down with your head raised on several pillows also helps to stop bleeding. Apply an ice bag or cold compress to the cheek on that side. Be sure you take all the medications the doctor prescribed for you, and remain calm. If you are unable to control excessive bleeding, call our office. After 24 hours some minor bleeding may persist and it is not unusual to find a stain of saliva mixed with blood on your pillow.
Ice packs applied for 20 minutes on, then 20 minutes off, will aid in controlling the amount of swelling, but will not prevent it completely. Swelling will usually peak two to four days after surgery. After 24 hours apply moist heat to the swollen area. Use caution with heating pads, as some may burn facial skin.
Begin taking medication as prescribed by your doctor. It is best to take the initial dose before the anesthesia wears off. Don’t be afraid to use the medication as it is designed to make those first days after surgery more comfortable. When taking oral medication, drink at least ½ cup of water, or juice to aid in absorption and reduce stomach irritation. Ibuprofen can also be helpful when used in conjunction with your pain medication for discomfort and swelling. After 24 hours continue to take your medications if pain persists. Usual side effects from medication should be reported to the office. Warm oral rinses (see “Oral Hygiene”) will reduce discomfort as well as improve hygiene.
It is important that you have something cold to eat, drink plenty of fluids and avoid using a straw. Please remember to remove the gauze pad before eating, drinking and taking medications. Water and juices are good choices. Soft, cool foods such as ice cream, smoothies, pudding, yogurt, Jell-O, and applesauce should be eaten at meal times, if possible. If swallowing is difficult, meals may have to be eaten five to six times daily in small portions. After 24 hours add more solid foods to your diet as it becomes more comfortable to chew. It is best to avoid crunchy, hard foods like popcorn, nuts and chips for one week following surgery.
Avoid rinsing, spitting and sucking through straws as this may dislodge the blood clot and delay healing. The day after the surgery begin rinsing every four to six hours, especially after meals, with a solution of warm salt water (1/2 teaspoon salt dissolved in 1/2 glass of warm water). Continue oral rinses at least four times a day for the first week following surgery. As tenderness decreases, you may resume your regular oral hygiene. Cleanliness is important for uncomplicated recovery, as food left in the surgery site may slow healing and promote infection. Avoid mouthwash as they may irritate the area and delay healing .
Nausea and Vomiting
It is not uncommon to experience nausea or vomiting. Medications, anesthetics, diet change and swallowed blood can easily upset your stomach. A small bland meal or clear carbonated beverage (Sprite, Ginger Ale) may coat your stomach and help alleviate your discomfort.
Immediately following procedure, reduce your activity as much as possible. Too much chewing or talking will contribute to greater swelling. It is best to nap with your head elevated on several pillows. Rest is important to start you on a good recovery. After 24 hours and the few days following surgery, you may increase your activity as tolerated, but avoid bending and heavy exercise through the first week.
In some cases, discoloration of the skin follows swelling. The development of black, blue, green, or yellow discoloration is due to blood spreading beneath the tissues. This is a normal post-operative occurrence, which may occur 2-3 days post-operatively. Moist heat applied to the area may speed up the removal of the discoloration.
If numbness of the lip, chin, or tongue occurs there is no cause for alarm. As stated before surgery, 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. So be careful. Call Dr. Thigpen 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.
After surgery you should be careful going from the lying down position to standing as it may make you dizzy. Pain medication can also make you light headed when you stand up suddenly. Before standing up, you should sit for one minute then get 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 Dr. Thigpen.
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 post-operative event which will resolve in time.
Sutures are sometimes 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 form your mouth and discard it. The sutures will be removed approximately one week after surgery. The removal of sutures requires no anesthesia or needles. It takes only a minute or so, and there is no discomfort associated with this procedure. So it’s really nothing to worry about.
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 my office for instructions.
There will be a cavity where the tooth was removed. The cavity will gradually over the next month fill in with the new tissue. In the mean time, the area should be kept clean especially after meals with salt water rinses or a toothbrush.
Your case is individual, no two mouths are alike. Do not accept well intended advice from friends. Discuss your problem with the persons best able to effectively help you: Dr. Thigpen 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 to 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 light headed, stop exercising.