Patient Instructions After Wisdom Tooth Removal
Kent Auburn Oral Surgery – Kent & Auburn WA
The removal of impacted wisdom teeth is a serious surgical procedure. Post-operative care is very important. Unnecessary pain and complications such as infection and swelling can be minimized if these instructions are followed carefully.
Immediately Following Surgery
- The gauze pad placed over the surgical area should be kept in place for at least one hour. Then wash your hands thoroughly before carefully removing the gauze from your mouth and discard.
- Vigorous mouth rinsing and/or touching the wound areas following surgery should be avoided. This may initiate bleeding by causing the blood clot that has formed to become dislodged. If we send a syringe home with you please do not use it until 1 week after surgery.
- It is recommended that you eat and drink after the gauze is removed and before beginning medications. Generally, a soft or liquid diet will be more comfortable for you. After medications replace new gauze as long as active bleeding is present. Fold one piece of gauze and place it right over the surgical site avoiding placement over adjacent teeth so pressure is applied over the wound. Bite down continuously for no less than two hours before checking for bleeding.
- Take the prescribed pain medications as soon as you begin to feel discomfort. This will usually coincide with the local anesthetic becoming diminished. It is especially important with antibiotics (e.g. Amoxicillin) to take them as prescribed.
- Restrict your activities on 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 a more thorough explanation.
- It is important to keep your mouth clean. Starting the day after surgery, dissolve about a quarter of a teaspoon of salt in an 8 oz. glass of warm water. Hold this warm water over the surgical sites inside your mouth, gently swish then expectorate. Do this after each meal and a few times in between for at least 1 week. Warm water rinsing helps to flush away particles, which may be lodged in the surgical site; it also soothes and promotes healing of the tissues. Regular teeth flossing and brushing can be resumed on non-surgical areas after surgery.
- No Smoking is advised during the first 7 days to promote healing.
- It is important for the patient who has had intravenous sedation or general anesthesia to stay home and rest for the remaining day of surgery. All surgery patients should get adequate rest and avoid exercise or strenuous activities for 5-7 days after surgery. No bending over or lifting heavy objects.
- You have been a terrific patient, THANK YOU! It is important to follow all instructions to best prevent healing complications.
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 two hours. Repeat if necessary. If bleeding continues, bite on a moistened black tea bag for thirty minutes. The tannic acid in the black tea 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: Auburn Office Phone Number 253-833-9524.
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. Two baggies filled with ice, or ice packs, should be applied to the sides of the face where surgery was performed. Apply the ice packs 20 minutes on and 20 minutes off for the first 2-3 days following the surgery. After 36 hours, ice has no beneficial effect. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery. 36 hours following surgery, the application of moist heat or heating pad to the sides of the face is beneficial in reducing the size of the swelling.
For moderate pain, one or two tablets of Tylenol or Extra Strength Tylenol may be taken every 3-4 hours. Ibuprofen (Advil or Motrin) may be taken instead of Tylenol. Ibuprofen bought over the counter comes in 200 mg tablets: 2-3 tablets may be taken four times daily, not to exceed 3200mg daily for an adult. Consult our practice for individuals under 18. Do not take the two medications at the same time.
For severe pain, the prescribed medication should be taken as directed. Do not take any of the above medications if you are allergic to them, or have been instructed by your doctor not to take it. 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: Auburn Office Phone Number 253-833-9524.
Diet and Food Information
After general anesthetic or IV sedation, only liquids should initially be consumed. Drink from a glass and do not use straws. The sucking motion can cause more bleeding by dislodging the blood clot. You may eat anything soft by chewing away from the surgical sites. A high calorie, high protein intake is very important. Our staff can provide suggested diet instructions. 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 any meals. 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 up for one minute before standing.
Keep the Mouth Clean
No rinsing of any kind should be performed until the day following surgery. The day after surgery you should begin rinsing at least 5-6 times a day, especially after eating, with a teaspoon of salt mixed into one cup of warm water.
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 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 any other unfavorable reaction and contact our office immediately. Call the office if you have any questions: Auburn Office Phone Number 253-833-9524.
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 nausea subsides you can begin taking solid foods and the prescribed medicine.
- If numbness of the lip, chin, or tongue occurs there is no cause for alarm. As reviewed in your consultation, 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. Call Dr. Feider if you have any questions: Auburn Office Phone Number 253-833-9524.
- 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 could get lightheaded from low blood sugar or medications. Before standing up, you should sit for one minute before getting up.
- Occasionally, patients may feel hard projections in the mouth with their tongue. They are not roots; they are the bony walls that supported the tooth. These projections usually smooth out spontaneously. If not, they can be removed by Dr. Feider.
- 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 that will resolve in time.
Sutures are placed in the area of surgery to minimize post-operative bleeding and to help to heal. Sometimes they become dislodged. This is no cause for alarm. Just remove the suture from 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 usually no discomfort associated with this 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: Auburn Office Phone Number 253-833-9524.
There will be a void where the tooth was removed. The void will fill in with new tissue gradually over the next month. In the meantime, the area should be kept clean, especially after meals, with salt water rinses or a toothbrush.
Your case is unique, no two mouths are alike. Discuss any problems with the trained experts best able to effectively help you: Dr. Feider 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 near the ear may occur 2-3 days following surgery. Call the office if this occurs: Auburn Office Phone Number 253-833-9524.
If you are involved in regular exercise, be aware that your normal nourishment intake is reduced. Exercise may weaken you. If you get lightheaded, stop exercising.
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