Post-Operative Instructions: Wisdom Tooth Removal

After Placement of Tooth Extraction

The removal of teeth is a surgical procedure. Post-operative care is very important. Unnecessary discomfort and the complications of 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 a half hour. After this time, the gauze pad should be removed and discarded.
• 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 ibuprofen and Tylenol as soon as you begin to feel discomfort. This will usually coincide with the local anesthetic becoming diminished.
• Restrict your activities on the day of surgery.
• Place ice packs to the sides of your face where surgery was performed for the first 24 hours following surgery.

Bleeding

A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon. 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. Repeat if necessary. If bleeding continues, bite on a moistened tea bag 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 for further instructions.

Swelling and Bruising

Swelling and bruising are normal after surgery. Swelling will generally increase after surgery for the first two to three days and then begin to resolve over the course of a week. Swelling may be reduced by using ice packs in the affected region for 20 minutes on and then 20 minutes off during the first 24–48 hours. Keeping your head elevated on an extra pillow when you sleep or lie down can also help to minimize swelling after surgery.

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 postoperatively. Moist heat applied to the area may speed up the removal of the discoloration starting at day 3 postoperatively.

Diet

Drink plenty of fluids. Avoid hot liquids or food. 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 and high protein intake are very important. 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. Return to a normal diet as soon as possible unless otherwise directed.

Medications

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. Typically, antibiotics are prescribed for the night before the surgery as well as the morning of surgery for you to take with a small sip of water prior to IV sedation. Call the office if you have any questions.

You may be prescribed pain medications, take as soon as you begin to feel discomfort after ibuprofen and Tylenol have been started. This will usually coincide with the local anesthetic becoming diminished. It is recommended that 600mg of Ibuprofen (3 tablets) and 500mg Tylenol (1 tablet) be taken shortly after surgery before the local anesthesia wears off. These medications are spaced 3 hours apart. For example, at noon ibuprofen is taken, at 3 p.m. Tylenol is taken, at 6 p.m. ibuprofen is taken, at 9 p.m. Tylenol is taken and so on. If prescribed opioid pain medication, take as directed for any breakthrough discomfort. Do not take additional Tylenol if taking a narcotic pain medication. Do not exceed 3200mg ibuprofen in a 24-hour period or 4000mg acetaminophen in a 24-hour period. Do not take any of the above medication if you are allergic or have been instructed by your doctor not to take it.

If prescribed opioid pain medicine, they will make you groggy and will 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 gets worse after the 72-hour mark, it may require attention, and you should call the office.

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 foods and the prescribed medicine. Zofran will be prescribed for any nausea prior to surgery.

Oral Hygiene

Good oral hygiene is essential to good healing. No rinsing of any kind should be performed until the day following surgery. Brushing your teeth is okay — just be gentle at the surgical sites. The day after surgery you should begin rinsing at least 3-5 times a day with 10-15ml of the prescribed Peridex Solution, especially after eating. Do not vigorously swish, let mouthwash sit over surgical site for 30 seconds and then let gently drain from mouth. Do not use electric toothbrush or waterpik over surgical sites.

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^®.

Activity

Keep physical activities to a minimum immediately following surgery. If you excerise, throbbing or bleeding may occur. If this occurs, you should discontinue exercising. Keep in mind that you are probably not taking normal nourishment. This may weaken you and further limit your ability to exercise.

Avoid heavy weightlifting and strenuous physical activity for approximately 1 week.

Other Complications

• The gauze pad placed over the surgical area should be kept in place for a half hour. After this time, the gauze pad should be removed and discarded.
• 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 ibuprofen and Tylenol as soon as you begin to feel discomfort. This will usually coincide with the local anesthetic becoming diminished.
• Restrict your activities on the day of surgery.
• Place ice packs to the sides of your face where surgery was performed for the first 24 hours following surgery.

If you have questions, problems, or concerns, please call our office at 208.344.9115. www.alpinesa.com