Post-Operative Instructions: Wisdom Teeth Removal

Following the extraction of teeth, blood clots form in the remaining socket in order to prevent any post-extraction inflammation and infection; thus, it is essential to preserve these blood clots in the socket.

FOR THE FIRST 48 HOURS AFTER EXTRACTION:

  • DO NOT vigorously rinse your mouth as this may rinse away the blood clot.
  • DO NOT use drinking straws.
  • DO NOT smoke.
  • DO NOT disturb the extraction site with tongue or fingers.

BLEEDING

The bleeding of the extracted tooth for up to 24 hours is quite common after tooth extraction. To reduce bleeding, follow the steps below:

  • Bite on wet gauze after extraction for 1 hour.
    Bite on new gauze every 20 minutes if necessary.
    DO NOT lie down flat; use a pillow to elevate your head.
    Do not engage in physical activities for 2-3 days.

SWELLING

Swelling after tooth extraction is expected. The swelling is greatest 2-3 days after surgery, and may remain for an additional 3 days before it starts to resolve.

  • Apply ice packs directly to the site of surgery.
  • Keep it on for 20 minutes and then take it off for 20 minutes throughout the day.
  • After the first 24 hours, it is not necessary to continue cold packs.

POSTOPERATIVE DISCOMFORT

Pain after the extraction of teeth is inevitable, and once the numbness wears off, there may be some discomfort. However, this pain can be controlled by taking your medication, which may not necessarily make you feel completely comfortable.

  • DO NOT operate a motor vehicle or machinery while taking pain medication. It can make you drowsy.

INFECTION

After surgical operations, the chances of developing an infection are always there, although this is not common. If the operation performed has high instances of infection, then the patient can be prescribed some medicine.

  • Take the prescribed antibiotics until the dose is completed.
  • For women on oral contraceptives, using other means of preventing pregnancy during the antibiotic treatment period is advised. Antibiotics such as penicillin affect the efficacy of oral contraceptives.

SUTURES

In cases where more extensive processes have been performed, sutures (or stitches) may be used to assist in the healing process. If you are fitted with sutures, your surgeon will let you know this once the operation has been completed.

  • Sutures that dissolve should fall out in about 1-7 days.
  • The non-dissolvable sutures need to be removed as early as 7 to 10 days. However, most are removed at 3 weeks.

OTHER INSTRUCTIONS

If you have been under IV sedation or general anesthesia for your procedure, then you should relax at home and engage in light activities as tolerated.

For the next 24 hours after anesthesia:

  • DO NOT drive a vehicle or use any machinery or tools powered by electricity.
  • DO NOT drink alcohol such as beer.
  • DO NOT perform any form of high-intensity exercise such as running or weightlifting.

BRUSHING

  • Start regular oral hygiene either on the night of surgery or the following day, gently brushing as you get nearer to the surgical area.
  • DO NOT spit.

DIET SUGGESTIONS

  • Start with clear liquids, like apple or cranberry juice, 7 Up® or ginger ale.
  • Gradually advance dietary intake on the first day, depending on tolerability, like Jell-O®, applesauce, or milk shakes.
  • Soft, non-chewable food can be eaten the first week after surgery, like mashed potatoes, scrambled eggs, or pasta.
  • AVOID eating popcorn, peanuts, seeds, or chips for two weeks post-surgery to reduce the risk of infection at the surgical site due to trapped food particles.
  • DO NOT rinse your mouth for the first 24 hours after surgery. After that, rinse gently with the oral rinse, if prescribed by your doctor, or with warm salt water (1/2 teaspoon salt dissolved in 8 ounces of warm water) 2-3 times a day for 1 week. Brush your teeth gently, but avoid the area of surgery for the first 24 hours.

WARNING SIGNS

In the event that any of the following happens, feel free to call us during regular office hours at (203) 327-7498. In case the problem arises outside regular office hours, you may call us at (203) 327-7498.

  • Bleeding that cannot be controlled by firmly biting on a gauze for 60 minutes.
  • Pain which is not controlled by the prescribed dose of medication. DO NOT take higher doses.
  • Persistent nausea or vomiting.
  • Swelling that continues to worsen beyond 72 hours, or any swelling that prevents one from swallowing.
  • A taste in the mouth that is extremely bad, regardless of regular mouth cleaning.
  • Temperature above 101 degrees Fahrenheit.

FAILURE TO FOLLOW INSTRUCTIONS MAY BE LIFE-THREATENING.

Our wish is for your healing process to be as comfortable as possible. These guidelines will help you, but should you have any queries about your recovery process, do not hesitate to contact us.

Home care instructions / answers to common questions:

BLEEDING

  • Following the extraction of your teeth, a gauze pack would have been placed over the extraction site, and you were instructed to close your jaws tightly for about 30 to 45 minutes. You might be required to change the gauze pack every 30 to 45 minutes if necessary. Please continue using the gauze packs for several hours following the surgery to ensure that the bleeding is under control. You will experience only slight bleeding before going to bed (you do not need to place the gauze while sleeping).
  • In case you suspect that the bleeding is not stopping, make sure that you place the gauze directly on the site of the bleeding and apply continuous pressure for 45 minutes. This method is quite effective in controlling the bleeding for the most part.
  • Other methods of dealing with the problem include using a teabag in its usual form. It needs to be placed on the extraction site and bitten down as described earlier. Tea contains tannic acid, which helps in clotting. In case you experience heavy bleeding, please call the doctor’s office.

DRY SOCKET

A dry socket means a blood clot that has disintegrated prematurely. A dry socket normally happens within three to five days post-operation. A dry socket occurs more frequently in women. It affects those who are smokers or have some other health problem that affects their healing process. Excessive physical exertion will lead you to develop a dry socket. Possible signs of a dry socket include increased pain and bad breath from your mouth. Normally, a pain caused by a dry socket spreads to your ear. Please let us know when you have such symptoms.

DIET

We suggest that you drink plenty of fluids and stick to a soft diet. Hot fluids should be avoided as they might cause the dissolving of the blood clot earlier than expected. You should avoid consuming alcohol since it might interact with your pain medication. Soft, thick, and creamy foods are advised for the first 5-7 days. Popcorn and other seedy foods, such as raspberries, should be avoided. Other foods that might easily lodge themselves in the surgical sites should also be avoided. Spitting, sucking through straws, and smoking should be avoided for one week after the procedure.

IRRIGATION SYRINGE

Starting on the fifth day after the procedure, clean the extracted tooth socket using the syringe provided below.

Instructions for use: stand in front of the mirror, and open your mouth to expose the area where the procedure was performed. Fill the syringe with warm water and touch the opening of the syringe to the area. Perform this process after meals and before sleep.

MEDICATIONS

Follow prescription directions. The medications have been prescribed to ensure pain management. As you heal, your pain will diminish. As your pain diminishes, you can reduce how often you take your pain medicine.

PLEASE NOTE: IF YOU ARE TAKING BIRTH CONTROL PILLS AND ARE PRESCRIBED ANTIBIOTICS, STUDIES HAVE SHOWN THAT ANTIBIOTICS CAN DECREASE THE EFFECTIVENESS OF BIRTH CONTROL PILLS FOR UP TO 30 DAYS.

ORAL HYGIENE/MOUTHWASH

Gentle brushing of your teeth should commence as early as possible. You should brush the biting surface of the teeth only as you approach the surgical sites with the toothbrush. Maintain oral hygiene by brushing your teeth regularly. You have been prescribed an anti-microbial mouth rinse. You should commence using it after 48 hours of surgery.

PHYSICAL ACTIVITY

Any kind of physical exercise that leads to an increase in your pulse should be avoided during the first five days post-operatively. Increased physical activities, causing an increase in your pulse, are associated with an increased risk of dry socket.

STITCHES (SUTURES)

Your stitches have been placed to control bleeding and encourage healing. These dissolve on their own in 10 to 14 days.

SWELLING

A certain amount of swelling accompanies nearly all tooth extractions. This is natural because it starts the process of healing. Swelling tends to be very pronounced following the extraction of impacted wisdom teeth. The application of an ice pack for up to 48 hours can alleviate the swelling. It will take between 36 and 48 hours for the swelling to peak. Note: You should avoid blowing your nose for one week after the extraction of upper wisdom teeth.

IF YOU HAVE ANY QUESTIONS ABOUT THESE INSTRUCTIONS OR ANY CONCERNS, PLEASE CALL OUR OFFICE (203) 327-7498.

PLEASE NOTE THAT PRESCRIPTIONS WILL BE FILLED OR REFILLED DURING OFFICE HOURS ONLY SO WE ARE ABLE TO VERIFY OFFICE RECORDS.

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