Post-Operative Instructions for Wisdom Teeth Removal

You’ve just had your wisdom teeth removed and now it’s time to rest and recover.  The first thing to keep in mind is that surgeries in the mouth usually heal quickly and without complication, especially if some simple precautions are taken.  Common sense will often dictate what you should or should not do. Here are some guidelines you should follow to minimize discomfort and help get you back to feeling your best.

IMMEDIATELY AFTER SURGERY:

The first few hours after surgery you might be in a bit of a fog, especially if you had sedation.  When you leave the office, you will have gauze in your mouth.  Continue biting gently, but firmly, on this gauze for about 30 minutes.  If the surgery areas are still bleeding after that, place new gauze (folded over a few times) over the wounds and bite down again for another 30 minutes. You can change the gauze as necessary from then on. It is best to moisten the gauze with tap water, and make sure you place the gauze far enough back in your mouth to compress the areas where the wisdom teeth were.  Biting on a moist tea bag wrapped in gauze may help control persistent oozing from the surgical site as tea contains an ingredient that promotes blood clotting.  Do not sleep or eat with gauze in your mouth.

TAKE ALL MEDICATIONS AS DIRECTED:  

As you might expect, oral surgery is typically accompanied by some degree of discomfort depending on both the procedure and patient tolerance. Before the numbness wears off, and after eating some food, start taking your pain medication.  Take 600mg of ibuprofen (eg Motrin or Advil) and 500mg of acetaminophen (Tylenol) AT THE SAME TIME, every 6 hours for at least three days.  This has been shown to be more effective than narcotics and opioids. Your goal is to take the medication BEFORE the pain starts.  It is much easier to stay ahead of the pain than to try and catch up once it starts.  DO NOT exceed the daily maximum of 3200mg of ibuprofen and 4000mg of acetaminophen.  If you cannot take either of these medications for any reason (such as an allergy or sensitivity), please inform the doctor and he will give you further instructions, or prescribe an replacement medication.  If you have difficulty swallowing the pills while you are numb, consider breaking them up into smaller pieces, or use a liquid form.  

Most pain from wisdom teeth extractions is due to inflammation, so you may have received a prescription for a steroid, which is an antiinflammatory medication.  Start taking this the DAY AFTER your surgery.

You may also have been prescribed an antibiotic.  If so, take it as instructed.  For women on birth control pills, antibiotics can decrease the effectiveness of oral contraceptives.  Proper precautions should be taken.  

With all medications, if you notice a rash, itching, hives, or difficulty breathing, stop taking the medication and immediately consult your doctor. 

It is important to continue any other regularly scheduled medication (for diabetes, blood pressure, etc.) unless otherwise advised.

WOUND CARE:

Do not disturb the area of surgery. You may brush your other teeth gently, avoiding the surgical area.  Also, limit physical activity for the first 24 to 48 hours.  Overexertion may lead to postoperative bleeding and discomfort. Please do not smoke for at least two weeks, as this is detrimental to healing and may cause complications; and do not drink alcohol for the next several days.  

If you have stitches, do not worry.  These will dissolve or fall out in 7 to 10 days.  

MOUTH RINSES:

Keeping your mouth clean after surgery is essential.  The day after surgery, you can start rinsing your mouth.  Use 1/4 teaspoon of salt dissolved in an 8 ounce glass of warm water, and gently rinse out your mouth using small increments at a time. Repeat as often as you like, but at least two or three times daily, preferably after meals. Avoid commercial mouth rinses, as most contain a small amount of alcohol in them.  If you were given a prescription mouth rinse, start it on day 5 and use it after breakfast and before bedtime. 

If you were given a small syringe, it is for flushing out the surgery areas when food gets trapped under the gums.  You can use either salt water or the prescription mouth rinse with it. Draw up some of the rinse in the syringe, then while placing the tip barely under the gums or in the area of the surgery, gently compress the plunger in short bursts, not all at once, to cleanse the area.  Do not force the syringe under the gums.  If there is no food getting trapped in the areas, you do not need to use the syringe. DO NOT use the syringe the first 48 hours after surgery.

SWELLING:

Oral surgery is often associated with post-operative swelling and sometimes bruising.  This is normal. It can be minimized by using a cold pack, ice bag or a bag of frozen peas wrapped in a towel and held over the cheek.  It is best to alternate sides every twenty minutes.  Never keep it over one area more than twenty minutes as you may cause injury, especially if you are still numb. This is most effective the first few hours after surgery.  Keeping your head elevated for the first several days may also help keep swelling to a minimum

DIET: 

Eating can be challenging the first few days.  Avoid anything extremely hot or cold.  Do not use a straw for the first few days. It is usually advisable to confine the first day’s intake to liquids or smooth foods (ice cream, soup, pudding, yogurt, milk, smoothies, etc). Also, stay away from foods that don’t dissolve such as nuts, popcorn and things with small seeds.as these may get lodged in the surgical sites. Over the next several days you may gradually progress to solid foods. If you are diabetic, maintain your normal eating habits or follow instructions given by your doctor.

Remember, you just had a surgical procedure. Be kind to yourself.

It is our desire that your recovery is as smooth and comfortable as possible. Following these simple instructions will assist you in your recovery. If you have any questions about your progress, please contact us directly.