AFTER WISDOM TOOTH REMOVAL

Immediately Following Surgery:

• The gauze pad placed over the surgical area should be kept in place for one hour. After this time, the gauze pad should be removed and discarded. Repeat as necessary to stop the bleeding.
• 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.
• Start the prescription medications after getting home.
• Restrict your activities the day of surgery. Stay home that day, but resume normal activity when you feel comfortable.
• Be careful to get up slowly. Rising quickly from sitting or especially lying can cause dizziness or fainting, which can result in serious injury from a fall.
• Place ice packs to the sides of your face where surgery was performed. Refer to the section on swelling for explanation.

Bleeding
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 bite firmly for thirty minutes. It is important to fold the gauze such that the pad end is small enough to place it directly on the surgical site - not on the adjacent teeth. Repeat as necessary. Avoid spitting. If bleeding continues, use a moistened tea bag instead of the gauze pads and bite for thirty minutes. The tannic acid in the tea may help to form a clot . To minimize further bleeding, do not become excited, avoid lying flat(use a few pillow behind your upper back and head), and avoid exercise. If bleeding does not subside, call the office.

Swelling and Stiffness
Swelling around the mouth, cheeks, eyes and sides of the face is not uncommon. This is the body’s normal reaction to surgery. The swelling will reach its maximum at 3-4 days after surgery. The swelling may be minimized by the use of ice packs for the first 24 hours. Two baggies filled with ice, or ice packs should be applied to the sides of the face where surgery was performed. The ice packs should be cycled: on for 10 minutes and off for 10 minutes. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery. Patients often have stiffness. It can be slight or more pronounced. It will resolve in 1-2 weeks. Start gently stretching the jaw open after a few days following surgery.

Pain
Please take the medication as prescribed. If you have any questions please call us.
Some medications can make you groggy and will slow down your reflexes. Do not drive an automobile or work around machinery while taking these drugs. 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.

Diet
After I.V. sedation, liquids should be taken at first. Do not use straws. Drink from a glass. The sucking motion can cause more bleeding. A small dish of plain ice cream is recommended as soon as you get home after surgery. You may eat anything soft but chew away form the surgical sites. High calorie, high protein intake is very important. Nourishment should be taken regularly. You should prevent dehydration by taking fluids regularly. At least 5-6 glasses of liquid should be taken daily. Try not to miss a meal. You will feel better, have more strength, less discomfort and heal faster if you continue to eat. Eat what you are able, depending on the amount of stiffness present. Soft foods are easiest, but eat what you like.

Oral Hygiene
No rinsing should be done on the day of the surgery. The day after surgery you should begin rinsing at least 5-6 times a day with the prescribed mouthwash or warm salt water.

Wound Care
For many cases, the surgical site where the lower wisdom teeth were removed will open after a few days. This is not cause for alarm; the site just wants to heal like an open extraction socket. However, this will require more careful cleaning, as the site will collect food and debris and be more prone to infection and delayed healing. Flush down inside the opening using the provided syringe with warm water 2-3 times a day, for approximately 1 month. To be effective, you must place the tip of the syringe inside the opening where the tooth was removed.

Discolouration
In some cases, discolouration (bruising) of the skin follows swelling. This may be black, blue, green, or yellow. This is a common post-operative occurrence, which may occur 2-3 days post-operatively. Moist heat applied to the area may speed up the removal of the discolouration.

Antibiotics
If you have been prescribed antibiotics take the tablets or liquid as directed. Discontinue antibiotic use in the event of a rash, diarrhea or other unfavourable reaction. Call the office if you have any questions.

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 pain medicine). You should then sip on water. You should sip slowly over a fifteen-minute period. When the nausea subsides, you can begin taking solid foods and the prescribed medicine. Over-the-counter Gravol may be used. If you have any concern, feel free to call the office.

Other Complications

• Slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office.
• Occasionally, patients may feel hard projections in the mouth with their tongue. They are not roots, they are the bony walls which supported the tooth. These projections usually smooth out spontaneously. Sometimes a piece of the bone may separate and come out through the gums. Again there is no cause for alarm. If there is persistent pain, call the office to make an appointment to be seen.
• 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. This will subside in 2-3 days.
• Stiffness of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a normal post-operative event, which will resolve in time. Warm packs and gently stretching the jaw starting 2-3 days after surgery will speed the recovery.
• If numbness of the lip, chin or tongue occurs there is no cause for alarm. This is usually temporary. Call the office if you have any questions about this or if it persists longer than 3 weeks.

Please Note

• Sutures are placed in the area of surgery to minimize post-operative bleeding and to help healing. Sometimes they become dislodged, this is no cause for alarm. Just remove the suture form your mouth and discard it. The sutures used are usually dissolvable and come away on their own 5-8 days post-operatively.
• 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 the office for instructions.
• A sore throat may develop. This is not cause for concern and will subside in 2-3 days.
• There may be a cavity (crater, hole ) where the tooth was removed. This will gradually, over the next month, fill in with the new tissue. In the mean time, the area should be kept clean, especially after meals with hot water rinses by means of the irrigation syringe.
• Your case is individual, no two mouths are alike. Do not take seriously well intended advice from friends. Do not hesitate to call us if you have any questions, we are more than happy to be available.
• Brushing your teeth is good - just be gentle at the surgical sites.
• A “dry socket” is a painful condition that can arise about 5th day after surgery. This occurs when the blood clot dissolves prematurely from the tooth socket. Seen occurs almost exclusively in women and more commonly in women on birth control medication. Symptoms of pain at the surgical site and even pain to the ear or headache may occur. Call the office if this occurs.
• If you are involved in regular exercise be aware that surgery and the associated changes in life habits may weaken you for a few days. Avoid exercise until you regain your normal strength. If you get light headed, stop exercising.
• We leave it to the patient if they want to come in for us to have an after care check-up. There is no fee for this visit. Most patients don’t need this check-up and prefer not to come in if they don’t have to.

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