Post-operative Instructions Following

 Wisdom teeth and extractions

 

As you have just completed a significant surgical procedure, success and comfort is imperative on your compliance with post-operative care instructions.

Bleeding

Expect bleeding for 6-8 hours following surgery. After that period, slight bleeding, oozing, or redness in the saliva may continue for 24 hours.  This type of bleeding is controlled by placing a moist gauze pad over the area and biting firmly for a minimum of 45 minutes. Repeat if necessary. If bleeding persists, place a black teabag into warm water as if you were making hot tea, squeeze the excess water out of the tea bag and bite firmly for 45 minutes. To minimize further bleeding, avoid strenuous exercise or anything that may increase blood pressure and keep head elevated. If bleeding does not subside or is excessive, call our office at 913-451-7680.

Pain

Ibuprofen (Motrin or Advil) 600mg every 6 hours is standard first line pain medication.  Under 16 years of age take as directed by the bottle.  For standard 200 mg over the counter pills and tabs, this equals 3 tabs (600 mg). Alternatively, Tylenol or Extra Strength Tylenol may be taken every four to six hours if not using prescription pain medication. We do not recommend Tylenol as a first choice, unless your dentist/physician has directed you to not take Advil or aspirin for a medical condition (blood thinners, taking other non-steroidal anti-inflammatories (NSAID’S), and/or ulcers).  If narcotic pain medication is prescribed, it will make you groggy and will slow down your reflexes. Do not drive an automobile, sign legal documents, work around machinery, and avoid any alcoholic beverages. Pain and/or discomfort following surgery is expected for 5-7 days, with maximum soreness at day 3. If pain persists despite pain medication, it may require attention and possible evaluation. Please contact our office with any questions and/or concerns of healing at 913-451-7680. 

Dry Socket

If increasing pain at the surgical site occurs 3-4 days following surgery, that does not improve with pain meds, you may be developing a ‘dry socket.’  A dry socket occurs when the blood clot dissolves prematurely and there is inflammation in the bone. Patients typically experience a throbbing and radiating pain. Begin using heat if you have not done so. Please call the office if this is suspected at 913-451-7680. 

Swelling

Swelling is expected and normal around the mouth, cheeks, eyes and sides of the face. The swelling will develop usually on post op day one and peak between days 3-4. It is normal to have limited opening for 3-4 days.  The swelling may be minimized by the immediate use of ice packs and should be applied to external face where surgery was performed. The ice packs should be left on an awake patient for 20 minutes, then removed for 20 minutes. Discontinue ice after 36 hours and begin using heat (heating pad or warm compress) alternating sides every 20 minutes. This will help alleviate pain and increase the range of motion. The recovery process will be expedited with consistent heat application.

Diet 

Your food intake may be limited for the first few days. You may start eating a soft diet such as yogurt, pudding, mashed potatoes, oatmeal, shakes and smoothies as soon as the numbness wears off.  High calorie, high protein intake is very important, as well as staying hydrated with 5-7 glasses of a non-carbonated liquid per day. Avoid the use of straws.  Take pain medication with food; doing so on an empty stomach may lead to nausea, dizziness and vomiting.

Oral Hygiene

No rinsing or brushing of any kind should be performed until the day following surgery. Begin rinsing at least four times a day gently, especially after meals with a glass of warm water mixed with a tablespoon of salt the day after surgery.  Avoid any vigorous mouth rinsing.  There will be a “hole” where the tooth was removed. The cavity will gradually close over the next couple of weeks, with the new tissue forming at the deepest portion first. In the meantime, the area should be kept clean with salt-water rinses, a toothbrush, or a plastic syringe if provided.  Gently irrigate the socket with syringe after meals and at bedtime.  Start using syringe 4 days after procedure with lukewarm tap water only. Failure to adequately irrigate can lead to surgical site infections.

Bruising

The development of black, blue, green, or yellow discoloration 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, after the second post-operative day.

Antibiotics

If you have been prescribed antibiotics, take the entire course of antibiotics as directed. Discontinue antibiotic use in the event of any trouble breathing, rash or other unfavorable reaction. Call the office immediately, if these symptoms arise and/or you have any questions at 913-451-7680.

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 pear juice, tea or ginger ale.  If you have more than one episode of vomiting, please call the office to inform us.   Caution: You may become dizzy or light-headed upon suddenly sitting up or standing from a lying position.  If possible, have someone monitor you upon sitting up and make sure you sit for one minute before standing.

Additional Information

• If numbness of the lip, chin, or tongue persists after the first day of surgery, please call our office. 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.
• Slight elevation of temperature immediately following surgery is not uncommon. If a temperature of 100.4° or higher persists beyond 24 hours, notify the office. Tylenol or ibuprofen should be taken to reduce the fever.
• As you heal, occasionally you may feel hard projections in the mouth with your tongue. Do not touch them with your fingers and do your best to avoid with your tongue. They are not roots; they are small pieces of the bone, which will likely resolve within a couple of weeks.
• If the corners of your mouth are stretched, they may dry out and crack. Your lips should be kept moist with a new, clean lip balm, or ointment.
• Sore throats and pain when swallowing are common. The muscles get irritated and swollen. This will usually subside in 3-4 days. Increased liquid intake will help shorten the duration of discomfort.
• If sutures were placed during your surgery, sometimes they become dislodged, do not be alarmed. Remove the suture from your mouth and discard it. The sutures will be absorbed in approximately one week after surgery and require no removal.

Every case and patient is different, therefore be cautious accepting well-intended advice from friends, family, co-workers or the internet. We are not done treating you until you are healed! 

If you have any questions or concerns following your surgery, please don’t hesitate to call our office at 913-451-7680.