After Wisdom Tooth Removal

The removal of impacted teeth is a serious surgical procedure. Post-operative care is very important. Unnecessary pain and complications such as infection and swelling can be minimized if these instructions are followed carefully.

ACTIVITY

· Rest, as much as possible for the next 24 hours. Avoid lying flat for the remainder of the day.
· Avoid strenuous activity for the next 4 days.

BLEEDING

· Gauze packs are in place over the extraction sites to help stop the bleeding.
· When you get home, replace the gauze and hold good tight pressure on the area for 1 hour. Remove the gauze, look at the extraction sites. If the sites are still bleeding use new gauze and continue holding pressure. Be sure to place the gauze over the extraction site. Check the bleeding every hour. Do not use the gauze to judge the bleeding. Actually look at the surgical site.
· Some oozing is normal for the first 24 hours. You should expect to see some bloody saliva over the next several days.

STITCHES

· Stitches are in place. They will eventually come out on their own within 7 to 10 days.

SWELLING

· You can expect swelling for the next 3 to 4 days. Typically, swelling will start on the second day. The swelling will be the worst on days 2 and 3 and should start to gradually get better.
· You should keep an ice pack on the side of the face as much as you can for the next 24 hours. Place it on one side for 30 minutes and then switch to the other side. Do not ice while sleeping.
· After 36 hours, switch to moist heat.

PAIN

· It is normal for pain to get worse over the next couple of days. Most discomfort is seen on day 2 and 3.
· Once you get home and the bleeding has stopped, you should eat (soft foods, pudding, etc.).
· After eating, start taking the Ibuprofen/Acetaminophen. Repeat the Ibuprofen/Acetaminophen every 6 hours for the next 3 to 4 days. This will help to decrease pain as well as swelling.
· For more severe pain, add the narcotic pain medicine in between doses of the Ibuprofen/Acetaminophen.
· Do not take the Ibuprofen/Acetaminophen and the narcotic pain medicine at the same time because this will likely make you sick. You should alternate the narcotic and Ibuprofen/Acetaminophen every 3 hours. Always take your medication with food; taking pain medication on an empty stomach can make you sick.
· Do not drive or operate machinery while taking narcotic pain medication.

DIET

· Drink as much clear fluids and water as possible.
· Maintain a soft diet for the next several days. Luke warm soup, mashed potatoes, yogurt, pudding, etc. keep your calorie intake up to promote healing. Boost, Ensure or Carnation Instant Breakfast are nutritious and will help keep your energy up.
· Avoid hot foods or liquids for the first 24 hours.
· Avoid foods like nuts, seeds, popcorn and hard crunchy foods for the first week.
· Do not smoke.
· Do not consume alcoholic beverages for 24 hours following surgery or while taking pain medication.

ORAL HYGIENE

· Try not to disturb the surgical area today. Do not rinse mouth today.
· Starting tomorrow, rinse with warm salt water 3 to 4 times a day. Rinse with the antibiotic mouth rinse three times a day for the next week.
· Starting tomorrow, gently brush teeth being careful in the surgical area, unless the doctor has instructed otherwise.

IF YOU HAD IV SEDATION, DO NOT DRIVE FOR 24 HOURS, OPERATE HEAVY EQUIPMENT, USE POWER TOOLS, OR SIGN LEGAL DOCUMENTS

Sutures are placed in the area of surgery to minimize post-operative bleeding and to help healing. Sutures should dissolve in 7 to 10 days. Sometimes they become dislodged. This is no cause for alarm. Just remove the suture from your mouth and discard it. The sutures will be removed approximately one week after surgery. The removal of sutures requires no anesthesia or needles. It takes only a minute or so and there is usually no discomfort associated with this procedure.

The pain and swelling should subside in 3 to 4 days following surgery. If your post-operative pain or swelling worsens or unusual symptoms occur, call our office for instructions.

There will be a void where the tooth was removed. The void will fill in with new tissue gradually over the next month. In the meantime, the area should be kept clean, especially after meals, with salt water rinses or a toothbrush.

Your case is unique, no two mouths are alike. Discuss any problems with the trained experts best able to effectively help you.

Brushing your teeth is okay — just be gentle at the surgical sites.

A dry socket is when the blood clot gets dislodged prematurely from the tooth socket. Symptoms of pain at the surgical site and even pain near the ear may occur 2 to 3 days following surgery. Call the office if this occurs.

If you are involved in regular exercise, be aware that your normal nourishment intake is reduced. Exercise may weaken you. If you get light headed, stop exercising.