After Wisdom Tooth Removal
Sometimes the after-effects of oral surgery are quite minimal, so not all of the instructions may apply. Common sense will often dictate what you should do. However, when in doubt follow these guidelines or call our office for clarification. Our number is: San Mateo Office Phone Number 650-340-6141
DAY OF SURGERY
FIRST HOUR: Bite down gently but firmly on the gauze packs that have been placed over the surgical areas, making sure they remain in place. Once you arrive home, gently remove the gauze packs.
OOZING: It is normal to have blood in the saliva for the next 24-48 hours, which is called oozing. Intermittent oozing which can be mistaken for persistent bleeding is normal.
PERSISTENT BLEEDING: Bleeding should never be severe. If so, it usually means that the packs are being clenched between teeth only and are not exerting pressure on the surgical areas. Try repositioning the packs. If bleeding persists or becomes heavy you may substitute a tea bag (soaked in lukewarm water, squeezed damp-dry and wrapped in moist gauze) for 20 or 30 minutes. If bleeding remains uncontrolled, please call our office.
EXERCISE CARE: Do not disturb the surgical area today. Do NOT rinse vigorously or probe the area with any objects. You may brush your teeth gently. PLEASE DO NOT SMOKE for at least 48 hours, since this is very detrimental to healing and may cause a dry socket.
SWELLING: If you were provided an ice pack wrap, keep the compression wrap on for the next 48 hours. If you have been prescribed medicine for the control of swelling, be sure to take it as directed.
ICE PACKS: The ice packs for the compression wrap are used 30 minutes in, and 30 minutes out for the first 48 hours after surgery, during the awake hours. During the 30 minutes the ice packs are supposed to be in, switch out the warmed packs after 15 minutes for cold one, since they are small and warm up quickly. While using the packs during the day, they should be stored in the freezer, in the refrigerator overnight. It is important that the ice packs stay soft and pliable so that they can conform to the facial contours. Please keep the head wrap on as much as possible, and there is no need to interrupt sleep to place ice packs. You should not shower with the head wrap on.
PAIN: Unfortunately most oral surgery is accompanied by some degree of discomfort. You will usually have a prescription for pain medication. If you take the first pill before the anesthetic has worn off, you should be able to manage any discomfort better. Some patients find that stronger pain medicine causes nausea, but if you precede each pain pill with a small amount of food, chances for nausea will be reduced. The effects of pain medications vary widely among individuals. If you do not achieve adequate relief at first, you may supplement each pain pill with an analgesic such as Tylenol (acetaminophen). Some patients may even require two of the pain pills at one time. Remember that the most severe pain is usually within six hours after the local anesthetic wears off, and two days post surgery when the swelling peaks; after that your need for medicine should lessen. If you find you are taking large amounts of pain medicine at frequent intervals, please call our office. If you anticipate needing more prescription medication for the weekend, you must call for a refill during weekday business hours.
NAUSEA: Nausea is not uncommon after surgery. Sometimes pain medications are the cause. Nausea can be reduced by preceding each pain pill with a small amount of soft food, and taking the pill with a large volume of water, or cutting the pill in half, and taking the two halves an hour apart. Try to keep taking clear fluids and minimize dosing of pain medications, but call us if you do not feel better. Carbonated beverages may help with nausea.
DIET: Eat any nourishing food that can be taken with comfort. Avoid extremely hot foods. Do not use a straw for the first week after surgery. It is advisable to confine the dietary intake to soft foods (soups, puddings, yogurt, milk shakes, etc.), or anything that can pass through a blender first (pureed foods, like a thick paste). It is best to avoid foods that need to be chewed, like hard breads, nuts, popcorn, meats, etc., which may get lodged in the sockets and lead to pain and infections. It is important not to skip meals! If you take nourishment regularly you will feel better, gain strength, have less discomfort and heal faster. If you are a diabetic, maintain your normal eating habits or follow instructions given by your physician.
SHARP EDGES: If you feel something hard or sharp edges in the surgical areas, it is likely you are feeling the bony walls which once supported the extracted teeth. Occasionally small slivers of bone may work themselves out during the following week or so. If they cause concern or discomfort, please call the office.
INSTRUCTIONS FOR THE SECOND AND THIRD DAYS
MOUTH RINSES: Keeping your mouth clean after surgery is essential. Use 1/4 teaspoon of salt dissolved in an 8 ounce glass of warm water and gently rinse with portions of the solution, taking five minutes to use the entire glassful. Please rinse at least two or three times daily for the next week following surgery.
BRUSHING: Begin your normal oral hygiene routine as soon as possible after surgery. Soreness and swelling may not permit vigorous brushing, but please make every effort to clean your teeth within the bounds of comfort.
HOT APPLICATIONS: After the first 2-3 days, you may apply warm compresses to the skin over the areas of swelling (hot water bottle, hot moist towels, or a heating pad) for 30 minutes on & 30 minutes off to help soothe tender areas. This will also help decrease swelling and stiffness.
HEALING: Normal healing after tooth extraction should be as follows: The first 2-3 days after surgery are generally the most uncomfortable and there is usually some swelling. On the third & fourth days, you should be more comfortable and, although still swollen, can usually begin a more substantial diet, although still blenderized. The remainder of the post-operative course should be gradual, steady improvement. If you don’t see continued improvement, please call our office. If you are given a plastic irrigating syringe, do NOT use it for the first five days. Then use it daily according to the instructions until you are certain the tooth socket has closed completely and that there is no chance of any food particles lodging in the socket.
It is our desire that your recovery be as smooth and pleasant as possible. Following these instructions will assist you, but if you have questions about your progress, please call the office where you had surgery. The doctor’s cell phone number is on the office answering machine, to contact the doctor after hours. Calling during office hours will afford a faster response to your question or concern.
PLEASE NOTE: telephone calls for narcotic (pain killer) prescription renewals are ONLY accepted during office hours.