AFTER WISDOM TEETH EXTRACTIONS
Immediately Following Surgery
• The gauze pad placed over the surgical area should be kept in place until you are inside your home. It can then be removed and discarded. Only replace the gauze if you have red bleeding.
• DO NOT use a straw for at least 2 weeks. Using a straw may initiate bleeding by causing the blood clot that has formed to become dislodged and this will delay or impede healing. It may also cause dry socket. Additionally, do not touch the now-healing surgical area.
• Take 800 mg of generic Ibuprofen or Advil at breakfast, lunch, dinner and bedtime for the next 7 to 10 days. For over the counter Ibuprofen, this is purchased as 200 mg pills, so you will need 4 pills each dose. If you still have pain one hour after taking Ibuprofen, take EITHER Extra Strength Tylenol, aka Acetaminophen, every 6 hours OR the narcotic, Vicodin or Hydrocodne, as prescribed, while still continuing the Ibuprofen. Please contact us at the office if you have any questions or for any clarification.
• Restrict your activities the day of surgery and resume regular activity only when you feel comfortable.
• Place ice packs to the sides of your face where surgery was performed. Refer to the section on swelling for further explanation.
• 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.
A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or pinkness in the saliva is common. Such pinkness represents the dissolving of the blot clot of the surgical area. Excessive bleeding, described as the mouth filling with blood, may be controlled by first rinsing or then placing a tight ball of gauze at the bleeding surgical area and putting direct pressure on the gauze with your finger for 10 minutes. If you run out of gauze (note: there is gauze provided in your take home kit), a moistened tea bag can be used in place of gauze. 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 quickly, or exercise. If bleeding does not subside, call for further instructions.
Swelling around the mouth, cheeks, eyes, and sides of the face is common following surgery. This is the body’s normal reaction to the surgery and plays a role in your healing. The swelling will not reach its peak until 36 to 48 hours post-operation. However, the swelling may be minimized by the immediate use of ice packs. Use an ice pack or small bag of frozen vegetables on your face to help with swelling. Apply the ice pack on the cheek following the angles of the jaw as much as can be tolerated for 48 hours. After 48 hours, ice has no beneficial effect, and the application of heat to the sides of the face is more effective in reducing the swelling. The ice pack that was provided by our team can be heated in the microwave or in hot water on the stove. If swelling or jaw stiffness persists for several days, there is no cause for alarm. Everyone is a little different, and this is a normal reaction to surgery.
You will start taking pain medications about 90 minutes after leaving our office, as specifically directed and noted by Dr. Clayhold talking with your friend and family before you left for home. Be sure to eat some food or drink a big glass of water when you take these medications to prevent an upset stomach.
You will take 800 mg of generic Ibuprofen or Advil at breakfast, lunch, dinner and bedtime for the next 7 to 10 days. For over the counter Ibuprofen, this is purchased as 200 mg pills, so you will need 4 pills each dose. If you still have pain one hour after taking Ibuprofen, take EITHER Extra Strength Tylenol, aka Acetaminophen, every 6 hours OR the prescribed narcotic, Vicodin or Hydrocodne while still continuing the Ibuprofen. Please contact us at the office if you have any questions or for any clarification.
The prescribed pain medicine, a narcotic, should only be taken as needed as it will make you groggy and will slow down your reflexes. While you are taking these to manage your pain, do not drive an automobile or work around machinery.
If you develop any uncommon to you rash, diarrhea, or other reaction reaction, it may be due to any medicine that we have given you. Please call the office. You may or may not be given a different prescription.
The expectation is that significant pain can be expected up to 14 days after surgery and to handle it most effectively requires attentive management and following our time-proven instructions consistently. Pain or discomfort following surgery should subside more and more every day, especially after 48 hours. If pain persists, it may require attention, and you should call the office to discuss.
You should maintain a soft diet (smoothies, eggs, well-cooked pasta, etc.) for 1 to 2 weeks. You may eat anything soft by chewing away from the surgical sites. Since your calorie intake of solid food will likely be lower for the first few days, you should compensate for this by increasing your fluid intake.
DO NOT use straws for 2 weeks! The sucking motion can cause more bleeding by dislodging the blood clot. Drink enough liquid to prevent dehydration. Try not to miss a meal. You will feel better, have more strength, less discomfort and heal faster if you continue to eat.
For more detail and suggestions, please visit the “Eating During Oral Surgery Recovery” section.
Keep the mouth clean
The evening of surgery you will begin using an antiseptic mouth rinse like Listerine, unless prescribed chlorhexidine or Peridex™. This will help with bad taste or odor of your healing mouth. You can also brush your teeth the night following surgery but work gently in the area of the surgery. The day after surgery you should rinse with Listerine 5 to 10 times a day especially after eating. Please note the instructions on the prescribed mouthwash are for 2 rinses a day, but you could use Listerine in between.
In some cases, bruising will occur near the surgical area. This is a normal post-operative occurrence 2 to 3 days after surgery.
If you have been placed on antibiotics, take the tablets or liquid as directed. Not all procedures require antibiotics. Discontinue antibiotic use in the event of a rash or other unfavorable reaction and let our team know of the reaction. Dr. Clayhold will likely prescribe an alternate antibiotic.
Nausea and Vomiting
In the event of nausea or vomiting following surgery, do not take anything by mouth for at least an hour including the prescribed medicine. Consider what should good to you and slowly sip on cola, tea, or ginger ale over a fifteen-minute period. When nausea subsides, you need to resume taking the prescribed medicine and begin taking more substantial foods. Stick with bland foods known to be easier on an upset stomach, such as bananas, rice, applesauce and toast.
• If numbness of the lip, chin, or tongue occurs, there is no cause for alarm. As discussed before surgery, this is usually temporary. But you must still be careful! If your lip or tongue is numb, you could bite it and not feel the sensation.
• Fever immediately following surgery is common. This is generally due to the combination of medicines for anesthesia and your other medicines. If the temperature persists more than 48 hours, please notify our office. If you are not already taking Tylenol, it should taken to reduce the fever.
• For a day or two, you should be careful going from the lying down position to standing. You could get lightheaded when you stand up suddenly. Before standing up, you should sit for one minute then get up. A few aspects of surgery lead to your being lightheaded. Since you were not able to eat or drink before surgery and since you may not be drinking enough fluid following surgery due to sleepiness or some numbness making it awkward. Additionally, taking pain medications can make you dizzy.
• Occasionally, patients may feel something sharp and loose at the surgical site. What you feel is caused by the natural and desired process of the jaw bone reforming. These will naturally smooth and reshape with time. However if they are extremely bothersome, contact the office to have them surgically removed.
• Since the corners of your mouth were stretched, they may be dry or cracked. Your lips should be kept moist with an ointment such as Vaseline™ or Chapstick™.
• Sore throats and pain when swallowing is not uncommon. When the muscles swell, the otherwise ordinary act of swallowing can then become painful. This will subside in 2 to 3 days.
• Stiffness, or Trismus, of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a normal post-operative muscle spasm as the body is naturally attempting to protect the area. The stiffness will resolve in time. If you would like, you can massage an stretch the mouth opening without concern about damaging the muscles.
Most likely you have stitches, or sutures, which will dissolve on their own. Sometimes they become dislodged, this is no cause for alarm. You may remove the suture from your mouth and discard it.
Some Final Things to Keep in Mind
The pain and swelling should subside more and more each day about 48 hours after the surgery. If your post-operative pain or swelling dramatically worsens or unusual symptoms occur, call the office for instructions.
There will be a hole in the jaw bone where the tooth was removed. The hole will gradually fill in with new tissue over the next month. In the meantime, keep the area clean especially after meals Listerine or the prescribed mouthwash.
• No two mouths are alike. If you have any issues, give us a call.
• Brushing your teeth is okay – just be gentle at the surgical sites.
• Sometimes pain to the ear may occur 2 to 3 days following surgery.