Surgical Instructions
After Wisdom Teeth Removal Instruction
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Immediately Following Surgery
- A gauze pad, rolled into a tight ball, should be placed over the surgical site and kept in place for a half hour. This will put pressure over the surgical area. After this time, the gauze pad should be removed and discarded. If additional bleeding occurs, repeat this step until the bleeding subsides.
- Vigorous mouth rinsing or touching the wound area following surgery should be avoided. This may initiate bleeding by causing the blood clot that has formed to become dislodged.
- Take the prescribed pain medications as soon as you begin to feel discomfort or about 2 hours after the procedure. This will usually coincide with the diminishing of the local anesthetic.
- Restrict your activities the day of surgery and resume normal activity when you feel comfortable.
- Place ice packs to the sides of your face where surgery was performed. Refer to the section on swelling for more explanation.
Bleeding
A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon. Excessive bleeding may be controlled by first rinsing or wiping any old clots from your mouth, then placing a gauze pad over the area and biting firmly for thirty minutes (see above instructions.) Repeat if necessary. If bleeding continues, bite on a moistened tea bag, wrapped in a gauze, for thirty minutes. The tannic acid in the tea bag helps to form a clot by contracting bleeding vessels. To minimize further bleeding, do not become excited, sit upright, and avoid exercise. If bleeding does not subside, call our office for further instructions.
Swelling
The swelling that is normally expected is usually proportional to the surgery involved. Swelling around the mouth, cheeks, eyes and sides of the face is not uncommon. This is the body’s normal reaction to surgery and eventual repair. The swelling will not become apparent until the day following surgery and will not reach its maximum until 2-3 days post-operatively. However, the swelling may be minimized by the immediate use of ice packs. Prepackaged ice packs, or two baggies filled with ice, should be applied to the sides of the face where surgery was performed. The ice packs should be left on continuously while you are awake, 20 minutes on and then 20 minutes off. After 48 hours, ice has no beneficial effect. Forty eight hours following surgery, the application of moist heat to the sides of the face is beneficial in reducing the size of the swelling. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery.
Pain
For mild pain, one or two tablets of Tylenol or Extra Strength Tylenol may be taken every three to four hours or Ibuprofen (Motrin or Advil) two to four 200 mg tablets may be taken every 3-4 hours.
For moderate to severe pain, take the tablets prescribed as directed. If you are prescribed a narcotic pain medicine (for example, Vicodin or Percocet), these medications may make you groggy and may slow down your reflexes. Do not drive an automobile or work around machinery. Avoid alcoholic beverages. Pain or discomfort following surgery should subside more and more every day. If pain persists, it may require attention and you should call the office.
Diet
After a general anesthetic or I.V. sedation, liquids should be initially taken. Do not use straws. Drink from a glass. The sucking motion can cause more bleeding by dislodging the blood clot. You may eat anything soft by chewing away from the surgical sites. High calorie, high protein intake is very important. Refer to the section on suggested diet instructions at the end of this section. Nourishment should be taken regularly. You should prevent dehydration by taking fluids regularly. Your food intake will be limited for the first few days. You should compensate for this by increasing your fluid intake. At least 5-6 glasses of liquid should be taken daily. Try not to miss a single meal. You will feel better, have more strength, less discomfort and heal faster if you continue to eat. Caution: If you suddenly sit up or stand from a lying position you may become dizzy. If you are lying down following surgery, make sure you sit for one minute before standing.
Keep the mouth clean
No rinsing of any kind should be performed until the day following surgery. You can brush your teeth the night of surgery, but rinse gently. The day after surgery you should begin rinsing at least 5-6 times a day especially after eating with a cup of warm water mixed with a half of a teaspoon of salt.
Discoloration
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.
Antibiotics
If you have been placed on antibiotics, take the tablets or liquid as directed. Antibiotics will be given to help prevent infection. Discontinue antibiotic use in the event of a rash or other unfavorable reaction. Call the office if you have any questions.
Nausea and Vomiting
In the event of nausea and/or vomiting following surgery, do not take anything by mouth for at least an hour including the prescribed medicine. You should then sip on coke, tea or ginger ale. You should sip slowly over a fifteen-minute period. When the nausea subsides you can begin taking solid or liquid foods and the prescribed medicine.
Other Complications
- 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 our office 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 were not able to eat or drink prior to surgery. It was also difficult to take fluids. Taking pain medications can make you dizzy. You could get 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 your doctor.
- If the corners of your mouth are stretched, they may dry out and crack. Your lips should be kept moist with lip ointment or 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.
Finally
Sutures may be placed 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 from your mouth and discard it. The sutures are usually dissolvable and should fall out or disappear in 3-7 days. If you have a suture that is not dissolvable, it will usually be removed by your doctor. There is no need for you to be nervous, this is not a painful procedure.
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 cavity where the tooth was removed and an irregularity of the gum tissue over the area. Over the following month, the cavity will gradually fill in with the new tissue and the overlying tissue will smooth over. 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: our doctors or your family dentist.
Brushing your teeth is okay – just be gentle at the surgical sites.
A “dry socket” can occur 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 worsen 3-5 days following surgery. Call our office if this occurs.
Answer to Question You May Have After Wisdom Teeth Removal
What should I do to manage pain and swelling?
Pain and swelling are common after wisdom teeth removal. Your surgeon will prescribe pain medications, which should be taken as directed. Applying ice packs to the outside of your cheeks in the first 24-48 hours can help reduce swelling. After 48 hours, you can switch to warm compresses to relieve any remaining swelling and discomfort.
When can I eat and what should I eat?
You can start eating soft foods as soon as you feel ready, usually within a few hours after surgery. Stick to soft, cold, or lukewarm foods like yogurt, applesauce, mashed potatoes, and smoothies. Avoid hot, spicy, or crunchy foods, as well as straws, which can dislodge the blood clot and lead to a painful condition called dry socket.
How should I care for the surgical site?
For the first 24 hours, avoid rinsing your mouth, brushing near the extraction site, or using mouthwash. After 24 hours, gently rinse your mouth with a saltwater solution several times a day, especially after meals. Be very gentle when brushing your teeth and avoid the extraction site to prevent disturbing the blood clot.
What is dry socket, and how can I prevent it?
Dry socket occurs when the blood clot that forms in the extraction site becomes dislodged, exposing the underlying bone and nerves. This can cause severe pain. To prevent dry socket, avoid using straws, smoking, spitting forcefully, or eating hard or crunchy foods for at least a week after surgery.
When can I resume normal activities?
Most patients can resume light activities the day after surgery, but it’s important to avoid strenuous exercise, heavy lifting, or any activities that increase your heart rate for at least 3-5 days. These activities can increase blood flow to the surgical site and cause bleeding or disrupt the healing process.
Is bleeding normal, and how do I manage it?
Some bleeding is normal within the first 24 hours after surgery. Bite down gently on the gauze pads provided by your surgeon for 30-45 minutes to control bleeding. If bleeding persists, replace the gauze and continue to apply gentle pressure. If bleeding is heavy or doesn’t stop after a few hours, contact your surgeon.
When should I take my prescribed medications?
Start taking your prescribed pain medication as soon as you begin to feel discomfort, typically before the local anesthesia wears off. If you’ve been prescribed antibiotics, take them as directed to prevent infection. Follow all instructions provided by your surgeon regarding medications.
When should I schedule a follow-up appointment?
A follow-up appointment is usually scheduled within 1-2 weeks after surgery to ensure proper healing. If you experience any unusual symptoms, such as severe pain, excessive swelling, or signs of infection, contact your surgeon before your scheduled follow-up.
