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.

Bleeding

Some bleeding or redness in the saliva is normal for 24-48 hours. Excessive bleeding (your mouth fills rapidly with blood) can be controlled by biting on a gauze pad placed directly on the bleeding wound for 30 minutes to 1 hour.   Bleeding may also be controlled by using a moistened black tea bag for 30 minutes.  The tea bag will release Tannic Acid helping to form a clot by contracting the blood vessels.  If bleeding continues profusely, please call for further instructions.

Swelling

Swelling is a normal occurrence after surgery. To minimize swelling apply an ice bag, frozen peas or corn works well, or a plastic bag or towel filled with ice, on the cheek in the area of surgery. Apply the ice continuously, 15 minutes on 15 minutes off (rotating one side to the other is best), as much as possible, for the first 24 hours.  After the first 24 hours, begin to apply warm moist compresses (use a wash cloth or hand towel moistened with warm water).  You may use the heat as much as you wish to aid in the swelling and stiff muscle recovery process. 

Pain

You should begin taking pain medication with food as soon as you fill your prescriptions or pick up any over-the-counter medicationsYou will only be numb for short time, so it is urgent that you start taking your pain medication ASAP.  For mild pain, 1 or 2 Tylenol or Extra Strength Tylenol may be taken every 4 hours. Ibuprofen (Advil or Motrin) may be taken instead of Tylenol. Ibuprofen bought over the counter comes in 200 mg tablets: 2-3 tablets may be taken every 6-8 hours as needed for pain. For severe pain, the prescribed medication should be taken as directed. Do not take any of the above medication if you are allergic to them, or have been instructed by your doctor not to take it.

Sinus Perforation

In the event that an upper tooth extraction causes a sinus perforation, you will be notified and the complication repaired.  DO NOT blow your nose, wipe only for 7-10 days.  If the need to sneeze occurs, try to redirect the air through your mouth instead of your nose.  Blowing your nose and sneezing may cause the need for additional surgery.

Diet

Drink plenty of fluids (DO NOT use a straw for 1 week). Avoid hot liquids or foods that must be chewed while you are still numb.  Soft foods that can be easily swallowed with no chewing are preferred while numb, (i.e. ice cream, yogurt, pudding, mashed potatoes, applesauce, etc).  Avoid hard and crunchy foods for one week, then you can return to a normal diet as soon as possible unless otherwise directed.

CAUTION: If you suddenly sit up or stand from a lying position you may become dizzy. If you are lying down following surgery, make sure you sit up for one minute before standing.

Keep the Mouth Clean

Good oral hygiene is essential to good healing.  NO brushing your teeth or rinsing the day of surgery.  Doing so could prevent proper clotting of the surgical site.  The day after surgery, brush  your teeth (even around surgical sites) gently.  Warm salt water rinses (one teaspoon of salt in a cup of warm water) should be used at least 4-5 times daily, especially after meals. 

Smoking

In all cases smoking is discouraged.  In the event you are a smoker, it is our recommendation that you stop for 7-10 days to allow for proper healing.  Smoking is the #1 cause of dry socket with tooth removal.  Smoking will slow the healing process.

Discoloration

In some cases, discoloration of the skin follows swelling. The development of black, blue, green, or yellow discoloration is due to blood spreading beneath the tissues. This is a normal post-operative occurrence, which may occur 2-3 days post-operatively. Moist heat applied to the area may speed up the removal of the discoloration.

Antibiotics

If you have been placed on antibiotics, be sure to take ALL of the medication. Antibiotics will be given to help prevent infection. Discontinue antibiotic use in the event of a rash or any other unfavorable reaction and contact our office immediately. 

Nausea and Vomiting

In the event of nausea and/or vomiting following surgery, call the office immediately.  A prescription for nausea and vomiting my be called in to control this rare complication.  In the time you are waiting for this medication to be called in, you may sip on coke, tea, or ginger ale. You should sip slowly over a fifteen-minute period. When the nausea subsides you can begin taking solid foods and the prescribed medicine.

Other Complications

  • If numbness of the lip, chin, or tongue occurs there is no cause for alarm. As reviewed in your consultation, this is usually temporary in nature. You should be aware that if your lip or tongue is numb, you could bite it and not feel the sensation. Call Drs. Kasper or Sclafani if you have any questions.
  • Slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office. Tylenol or ibuprofen should be taken to reduce the fever.
  • You should be careful going from the lying down position to standing. You could get light headed from low blood sugar or medications. Before standing up, you should sit for one minute before getting up.
  • Occasionally, patients may feel hard projections in the mouth with their tongue. They are not roots; they are the bony walls which supported the tooth. These projections usually smooth out spontaneously. If not, they can be removed by Drs. Kasper or Sclafani.
  • If the corners of your mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment such as Vaseline or a lip balm.
  • Sore throats and pain when swallowing are not uncommon. The muscles get swollen. The normal act of swallowing can then become painful. This will subside in 2-3 days.
  • Stiffness (Trismus) of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a normal post-operative event which will resolve in time.  Using warm moist compresses such as a wash cloth or hand towel starting the day after surgery will help alleviate the issue.  After several minutes of moist heat application, try to stretch (like a yawn) the jaw.  Stiffness of the jaw muscle is no different than a back or leg muscle, do not panic.

Finally

Sutures are placed in the area of surgery to minimize post-operative bleeding and to help healing. Sometimes they become dislodged. This is no cause for alarm. Just remove the suture from your mouth and discard it. The sutures are usually dissolving and in most cases do not have to be removed after surgery. 

The pain and swelling should subside more and more each day 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: Drs. Kasper or Sclafani or your family dentist.

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 2-6 days following surgery. Call the office if this occurs, this common post operative complication is treated in the office.

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.

AFTER HOURS – EMERGENCY PROCEDURE

Any issue that you think is life threatening call 911

If you have questions for Drs. Kasper or Sclafani regarding proper healing, medications or peace of mind:  Call Clinton Township Phone Number 586-226-2801 and choose option 7 in the automated system.  You will then be able to leave a personal voicemail, and the on call surgeon will call you back.  Be sure to leave your phone number!