After Wisdom Tooth Removal

Home Instructions After Wisdom Teeth Extraction

The removal of impacted wisdom teeth is a significant surgical procedure, and proper post-operative care is crucial to ensure a smooth recovery. By following these instructions carefully, you can minimize unnecessary pain, swelling, and complications such as dry socket.

Immediately Following Surgery:

Gauze Pad: Keep the gauze pad placed over the surgical area for 30 minutes. After this time the gauze pad should be removed and discarded.

Avoid Vigorous Rinsing: Do not rinse your mouth vigorously or touch the surgical area. This may initiate bleeding by causing the blood clot that has formed to become dislodged. Do NOT SWISH LIQUIDS OR RINSE WITH ANY PRESSURE AT ALL FOR 1 WEEK AFTER SURGERY. Instead, roll warm salt water back & forth with your mouth open and your head tilted back, then lean over the sink to allow the water to fall out of your mouth, then dry your mouth with a towel…do not spit.

Medications: Pick up all prescribed medications and begin taking them immediately on the first day. Your pharmacist may tell you to wait until the next day to start taking the steroid dose pack. DO NOT DO THAT. Take the pills from the missed “breakfast” dose along with the “lunch” pills after eating lunch and then follow the directions on the card from that point on. Take pain medication before discomfort starts to avoid feeling pain. If you do not experience any pain the next day, you do not need to continue taking the pain medications.

Activity: Limit your activities on the day of surgery. Resume normal activities when you feel comfortable.

Ice Packs: Apply ice packs to the sides of your face where surgery was performed. Refer to the “Swelling” section below for a more thorough explanation.

Bleeding

Slight bleeding, oozing, or redness in your saliva is to be expected following surgery. If bleeding becomes excessive, rinse or gently wipe away any old clots from your mouth, then place a MOISTENED gauze pad over the area and bite down firmly for 30 minutes. Repeat if necessary. If bleeding continues, bite on a moistened caffeinated black tea bag for 30 minutes. The caffeine &  tannic acid in the tea helps form a clot by constricting blood vessels. To reduce further bleeding, remain calm, sit upright, and avoid any physical activity. If bleeding persists, please contact our office.

Swelling

Swelling is a normal response to surgery and is usually proportional to the extent of the procedure. You can expect swelling around the mouth, cheeks, eyes, and sides of the face. This swelling will typically become noticeable the day after surgery and will peak 2-3 days post-operation. To minimize swelling, apply ice packs or frozen unopened peas or corn immediately after surgery. Ice packs should be placed on the sides of your face where the surgery was performed and should be alternated on for 20 minutes then off for 10 minutes continually while awake for the first 24 hours. After 24 hours, ice no longer provides any benefit. If swelling or jaw stiffness persists for several days, there is no cause for concern—this is a typical part of the healing process. After 24 hours, applying moist heat to the sides of your face can help reduce swelling. Take Pain Medications as prescribed. If you choose to take narcotic pain medication do not operate machinery or drive a vehicle for 8 hours.

Pain

For moderate pain, one or two tablets of Tylenol or Extra Strength Tylenol can be taken every 4-6 hours. Alternatively, Ibuprofen (Advil or Motrin) may be used instead of Tylenol. Over-the-counter Ibuprofen typically comes in 200 mg tablets; 2-3 tablets can be taken up to four times daily, with a maximum daily dose of 3200 mg for adults. Please consult our practice for guidance on usage for individuals under 18.

If the pain is significant, you can alternate between Tylenol and Ibuprofen. Start by taking one Extra Strength Tylenol, then wait 3 hours before taking 600 mg of Ibuprofen (Advil or Motrin). After another 3 hours, take another Tylenol, then wait another 3 hours before taking 600 mg of Ibuprofen again. Repeat this cycle until the pain subsides or becomes tolerable without medication.

For severe pain, take the prescribed narcotic medication as directed. Do not take any of the above medications if you are allergic to them or have been instructed by your doctor not to take them. Avoid driving, operating machinery, or consuming alcohol while on medication. Pain or discomfort following surgery should gradually improve each day. If the pain persists, it may require further attention, and you should contact our office.

Diet

In the first few hours after general anesthesia or IV sedation, only liquids should be consumed. Drink from a glass, and avoid using straws, as the sucking motion can dislodge the blood clot and lead to increased bleeding. After a few hours, you may eat soft foods (nothing harder than scrambled eggs), being sure to chew away from the surgical sites. It’s important to focus on a high-calorie, high-protein diet. Our staff can provide additional dietary recommendations.

Nourishment should be taken regularly to prevent dehydration. Aim to drink fluids consistently throughout the day. Your food intake may be limited during the first few days, so it’s essential to compensate by increasing your fluid intake. At least 5-6 glasses of liquid should be consumed daily. Try not to skip any meals. Continuing to eat will help you feel better, regain strength, experience less discomfort, and promote faster healing.

Keep the mouth clean

No rinsing of any kind should be performed until the day following surgery. The day after surgery, you may begin gently rinsing your mouth with saltwater. To do this, take a mouthful of saltwater, lean your head back, roll your head from side to side, and gargle at least 5-6 times a day, especially after eating. Use 1 teaspoon of salt mixed into 1 cup of warm water, and only use enough to fill your mouth. DO NOT USE ANY PRESSURE WHEN RINSING OR SWISHING LIQUIDS AROUND AS THIS CAN LOOSEN OR DISLODGE THE CLOT AND CAUSE A DRY SOCKET, WHICH CAN RESULT IN EXTREME PAIN.

You will have a follow-up appointment one week after surgery. During this appointment, Dr. Gadler will rinse out the sockets and remove any food that couldn’t be cleared using the saltwater rinse. Dr. Gadler or a staff member will then show you how to use a plastic syringe to clean out the sockets yourself. You’ll need to rinse the sockets every time you eat until they are fully healed and food is no longer getting trapped. Healing can take as little as one week or up to 12 weeks, depending on how quickly your body heals.

It is critical to keep the sockets clean. If food remains trapped in the sockets, the gum tissue may grow over it, causing the food to rot and leading to an abscess that requires surgical drainage. This would restart the entire healing process, so it’s important to keep the sockets clean to avoid complications. Once the sockets are fully healed and no more food is trapped, you can discontinue the syringe rinsing and return to your normal oral hygiene routine.

Discoloration

In some cases, discoloration of the skin may occur after swelling. The appearance of black, blue, green, or yellow discoloration is caused by blood spreading beneath the tissues. This is a normal post-operative occurrence and typically develops 2-3 days after surgery. Applying moist heat to the area may help speed up the process of discoloration fading. 

Antibiotics

If you have been prescribed antibiotics, take the tablets or liquid as directed. Antibiotics are given to help prevent infection. If you develop a rash or experience any other adverse reactions, discontinue antibiotic use and contact our office immediately. If you have any questions, please call the office.

Nausea and Vomiting

If you experience nausea and/or vomiting after surgery, do not take anything by mouth for at least an hour, including your prescribed medication. After an hour, you can slowly sip sugar-free sparkling water,  coke, tea, or ginger ale over a 15-minute period. Once the nausea subsides, you can begin eating solid foods and taking your prescribed medication.

Other Complications

• If you experience numbness in your lip, chin, or tongue, there is no need to worry. As discussed during your consultation, this is usually temporary in nature. However, if your lip or tongue is numb, you may accidentally bite it without feeling the sensation. 

• A slight elevation of temperature immediately following surgery is not uncommon. If the fever persists, please notify the office. You can take Tylenol or ibuprofen to help reduce the fever.

• Be cautious when transitioning from lying down to standing, as you may feel lightheaded due to low blood sugar or medications. Before standing, take a moment to sit for a minute to avoid dizziness.

• Occasionally, patients may feel hard projections in the mouth with their tongue. These are not roots but the bony walls that previously supported the tooth. These projections typically smooth out on their own. If they do not, Dr. Gadler can remove them.

• If the corners of your mouth are stretched, they may dry out and crack. Keep your lips moist with an ointment like Vaseline to prevent this.

• A sore throat and pain while swallowing are common after surgery due to swelling in the muscles. This discomfort should subside within 2-3 days.

• Stiffness (trismus) in the jaw muscles may make it difficult to open your mouth for a few days following surgery. This is a normal post-operative event and will resolve over time.

Finally

Depending on the case, Dr. Gadler may or may not place sutures. For wisdom teeth removals, Dr. Gadler typically uses resorbable sutures that dissolve on their own within 1-2 weeks. Occasionally, they may fall out early, which is almost never a concern. If this happens, simply remove the suture from your mouth and discard it. Sutures are placed to minimize post-operative bleeding and promote healing. If non-resorbable sutures are used, they will need to be removed about one to two weeks after surgery. Removing sutures is a quick procedure that doesn’t require anesthesia or needles, and it usually involves little to no discomfort.

Pain and swelling should subside more and more each day following surgery. If your pain or swelling worsens or if you experience any unusual symptoms, please contact our office for instructions.

There will be a void where the tooth was removed, which will gradually fill in with new tissue over the next month. In the meantime, it’s important to keep the area clean, especially after meals, by rinsing with saltwater or gently brushing with a toothbrush.

Every case is unique, and no two mouths are the same. If you have any concerns, please discuss our team of experts that can assist you.

It is okay to brush your teeth, but be gentle around the surgical sites.

A dry socket occurs when the blood clot is dislodged prematurely from the tooth socket. Symptoms of a dry socket may include pain at the surgical site and sometimes pain near the ear, typically 2-3 days after surgery. If this happens, please contact our office.

If you engage in regular exercise, be aware that your normal food intake may be reduced after surgery, which can make you feel weak. If you experience lightheadedness, stop exercising and rest.