Post-operative instructions for wisdom tooth extraction

Care of the mouth after surgery has an important effect on healing.  Swelling, discomfort, and restricted jaw function are expected, so need not cause alarm.  These may be minimized by following the instructions below— please read them carefully.

*Note, this are generic instructions, and your situation may be different from what’s listed below

  • Bleeding control
    • After the procedure, we will place gauze in the back of the mouth where the incisions are. It’s important that the gauze is back behind the last teeth so that it’s putting pressure right on the wounds. Biting down firmly on the gauze packing will help to stop the bleeding
    • Change the gauze every 30-45 minutes until the bleeding stops (usually 1-2 hours). Changing the gauze too frequently may cause prolonged bleeding
    • Remove gauze once the bleeding stops, or when eating, drinking or sleeping
    • If the site begins bleeding again, reinsert gauze and apply firm pressure again for 30-45 mins until it stops again
    • As another option, regular black tea bags may be used instead of gauze – put two in a small bowl, saturate with room-temperature water, and use as above. The tannin in the tea will help to stop bleeding as well
  • Prescriptions
    • Antibiotics are not routinely needed following the removal of wisdom teeth
    • You will most likely have a prescription for pain medications, please plan to pick them up on your way home from the office (or shortly after you get home)
    • You should start taking the prescribed pain medication as soon as you get home even if you’re not sore yet (so that it’s taking effect before the freezing starts to wear off)
    • See separate pain medication instructions for more details on appropriate use of pain medications
    • If you have been prescribed pain medicine with a narcotic (Tylenol #3, codeine, Percocet, Tramadol/Tramacet), do not drive while taking these medications
    • If you haven’t been prescribed pain medication, take over the counter pain medications like ibuprofen (Motrin, Advil) or Tylenol, as needed
    • If you develop hives or a rash, discontinue the medication and contact our office immediately
  • Swelling control
    • Swelling and bruising are normal and may continue to reach their peak 2-4 days after surgery, after which time swelling should plateau and then slowly decrease over the next week or so. Bruising may extend from the eyes to the collarbones
    • Apply ice packs to both cheeks 20 mins on 20 mins off, for the first 24 hours to reduce the amount of swelling
    • If you have a sudden increase in pain or swelling more than 5 days after your procedure, please call the office to make a follow-up appointment.
  • Diet
    • On the day of the procedure start with clear liquids (water, Gatorade, apple juice) using a cup or spoon. Avoid using straws for the first week, as any negative pressure in the mouth can cause dry sockets or disrupt the stitches
    • Once you are tolerating clear liquids well, move on to cool, soft foods for the rest of the day: e.g. milkshakes, Jell-O, pudding, protein shakes, smoothies, yogurt, applesauce, avocado, banana
    • The day after surgery, muscle stiffness and discomfort are the only restrictions to what you can eat or drink, so start with soft foods like scrambled eggs, mashed potatoes, pasta, soups, cooked vegetables, oatmeal, pancakes, meatloaf, macaroni and cheese. You can begin to progress your diet as tolerated from there
    • If you had teeth removed from the lower jaw, avoid foods with small hard pieces that can get stuck down in the sockets (popcorn, nuts, seeds, berries, tortilla chips ) for the first two months or until the sockets have healed over
  • Mouth opening exercises
    • It’s normal for mouth opening to be reduced for a while after surgery due to stiffness of the muscles that close your mouth. Starting the day after surgery, you must start stretching your jaw open until your mouth opening is back to normal levels again
  • Oral hygiene
    • Brush your teeth as usual but avoid brushing the gums at the surgical sites for 2 weeks
    • Beginning the day after surgery, rinse your mouth with warm salt water (1/2 tsp salt to a cup of warm water) after each meal and at bedtime for 2 weeks
    • IF we gave you an irrigation syringe, begin using it on the 4th day after surgery:_______________________. Gently syringe the lower extraction sites with warm salt water after eating and before bed for 2-3 weeks OR as long as needed to keep the pocket clean
    • Avoid over-the-counter mouthwashes (Scope, Listerine) for one week, as they may irritate the area
    • Stitches may be placed in some of the sites (not all sites require stitches), and these typically dissolve on the inside and fall out on their own in 3-5 days. Certain types of sutures may last longer, but will also be dissolvable. Try to leave them alone until they fall out
  • Nausea
    • Small sips of a carbonated drink (i.e Gingerale or Sprite) will usually help with nausea. Follow this with a clear diet: apple juice, clear tea, broths, and Jell-O.  If nausea continues, please contact our office for further instructions
  • Numbness
    • After your procedure, your mouth will be numb from the local anesthesia. This will last between 3 to 8 hours depending on the type used
    • If teeth were removed from the lower jaw, occasionally numbness of the lower lip, chin or tongue may persist after the freezing has worn off. This is rare and most often a temporary condition which will resolve on its own within 7-10 days.  If it has not resolved by 1-2 weeks after surgery, please call our office to schedule a follow-up appointment
  • Activity
    • Rest and relax on the day of the procedure – don’t try to push yourself on the first day even if you’re feeling well
    • It’s best to plan to be off work or school for 2-4 days after surgery, but after the first day you may gradually resume your normal daily activities as tolerated
    • Following IV sedation or general anesthesia, DO NOT drive for 24 hours or operate heavy machinery or sign legal documents
    • Avoid strenuous physical activity or workouts for 5-7 days, after which time it’s okay to gradually return to normal activity, but if your jaw is throbbing and aching when you get your heart rate up, you need more time to heal first
  • Smokers
    • Smoking dramatically increases the risk of a dry socket and also delays wound healing. Therefore, we ask that for your own benefit please DO NOT smoke for at least the first 48 hours (preferably 1 week)
  • Usual medications
    • Unless directed otherwise, you may take all your regular home medications without interruption

 

Keep in mind, the extent of your particular surgery will influence the magnitude of your symptoms during recovery.  The following conditions may occur and are not considered abnormal:

  • If you had general anesthesia for your procedure, a temporary sore throat or bleeding/discomfort in the nose may occur from the breathing tube that was in place for the surgery. This will get better with time
  • Your lips may be dry and cracked. Keep moist with lip balm
  • You may have a slight ear-ache or headache
  • If you suffered from TMJ pain prior to the procedure, this may be temporarily worsened
  • There may be a slight increase in your temperature for 24 to 48 hours. This does NOT mean you have an infection. If this continues past 48 hours, please contact our office

 If you have any questions at all, don’t hesitate to contact our office at 403-263-5193. During our regular business hours we’ll be happy to help you through any questions or problems you’re having, and outside of business hours you can call the same number and follow the prompts to be directed to the 24-hour on call surgeon.