Impacted teeth removal is a serious surgical procedure. Following post-operative instructions is very important, this can minimize pain and the complications of infection.
Anyone receiving general anesthesia for wisdom teeth removal must be accompanied by an adult who will remain in our office for the entire procedure, be responsible for driving the patient to the pharmacy to have prescriptions filled, and drive the patient home.
Immediately Following Surgery:
Eat something soft and cold (like ice cream or a milkshake). Remember, DO NOT use a straw. The sucking motion can increase bleeding by dislodging a blood clot. Fill your prescriptions at the pharmacy and begin taking medications AFTER EATING. There will usually be four medications for those who had impacted or partially impacted wisdom teeth. These medications include antibiotics, anti-inflammatory pills, pain relievers, and a prescription-strength mouth rinse.
Note: Start taking your oral medications (pills) right away, but wait until the day after surgery to start using the mouth rinse.
The treatment area in your mouth will be numb for several hours, but Dr. Dale Gallagher recommends that a pain pill be taken before the numbness has worn off. Keep in mind that the patient may not be in discomfort (because of the local anesthetic), but if the medication has already been taken, the transition from a numb mouth to an awake mouth will be much easier. In addition to lessening pain, there is usually an anti-nausea ingredient in the pain medication. Take a pain pill every 4 to 6 hours on the day of your surgery (with food). The pain medication will cause sleepiness, so the patient should not drive while taking the pain medication. Depending on the amount of discomfort on the day after surgery, Tylenol or Motrin/Advil may be all that the patient needs. Avoid taking aspirin for about 3 days unless our oral surgeon in Austin, Texas, instructs otherwise. Take all prescriptions as directed. If you have questions about the prescription instructions, call our office at 512-258-1636 and ask to speak with a surgical assistant.
Note: The anesthetic makes your mouth and throat numb. Even though the soft tissues surrounding these areas are numb, the muscles involved in swallowing still work. After you eat and try to swallow pills, if you find it impossible to swallow, simply rest for about 30 minutes and try again. If you are still not successful, open up the capsules, mash up the pills, and place them on top of a spoonful of ice cream or pudding and swallow. Creamy things are sometimes easier to swallow than pills and water. Be aware that you’re probably going to drool, so keep plenty of napkins around and a grubby shirt on.
After you eat and take your first round of medicine, you will likely want to nap. The general anesthesia and pain pill both cause drowsiness. It is ok to rest and sleep, but start using ice packs to help prevent swelling. Place the ice packs on the outside of your cheeks. You can get creative to figure out a way to hold the ice packs in place while you sleep. Some wrap an ace bandage under the chin and over the head to keep the ice packs in place. A long sock or pantyhose will serve the same function if you don’t have an ace bandage. Remember that most of the swelling won’t be seen until 2 or 3 days after surgery, so what you do now (ice today and exercise tomorrow) will make your recovery more comfortable and pleasant. After 36 hours, ice will have no effect. If you still experience swelling or jaw stiffness after several days, don’t worry; this is a normal reaction to surgery. Thirty-six hours after surgery, applying moist heat to the sides of the face is beneficial in reducing the size of the swelling.
Cold, soft foods should be eaten as long as you are numb. Remember to eat every time you take a pill. After the numbness has worn off, you may eat warm foods like soup, eggs, macaroni and cheese, and mashed potatoes. Avoid rice, foods with seeds, and hard, crunchy foods, as they can become lodged in the extraction sockets.
Slight bleeding, oozing, or redness in the saliva is to be expected after extraction. After you get your prescriptions, go get something cold and soft to eat. Remove your gauze before eating. After you eat and take your medicine, replace the gauze with fresh gauze and bite down firmly on it for 45 minutes to an hour, and then check for oozing. Repeat as necessary. If the bleeding still continues, bite on a moistened tea bag for 30 minutes. The tannic acid in the tea bag can help form a blood clot. This may continue for a few hours or up to two days. A small amount of blood when rinsing and brushing is normal up to 3 to 4 days after surgery.
- Relax on the day of your surgery, but get going the next day. Exercise speeds up the healing process and resolves swelling much more quickly.
- The stitches (sutures) will dissolve on their own in a week or two.
- Remember to follow the directions on your prescriptions and CALL IF YOU HAVE ANY QUESTIONS.
If you experience moderate pain, you may take 1 or 2 Tylenol or Extra Strength Tylenol every 3 to 4 hours. Ibuprofen may be taken instead of Tylenol. You may take 2 to 3 tablets every 3 to 4 hours as needed for pain. If you experience severe pain, take the prescribed medication as instructed. The prescribed medicine will make you groggy and slow your reflexes. Do not drive or work around machinery. Avoid alcoholic beverages. The pain or discomfort you experience should subside day by day. If pain persists, call our office.
Keeping Your Mouth Clean
Proper oral hygiene is imperative for healing. Brush at least two times a day (starting the day after surgery) and use your prescription mouth rinse twice a day (in the morning and at night). You may also use salt water rinses if desired. Avoid vigorous mouth rinsing and touching the wound, as these may cause bleeding by dislodging the blood clot. Do not use hydrogen peroxide. Also, do not use a Waterpik® near surgical areas.
Discoloration and Bruising
Sometimes, skin discoloration follows swelling. Black, blue, green, or yellow discoloration occurs because of the spreading of blood beneath the tissues. This common post-operative occurrence may happen 2 to 3 days after surgery. Apply moist heat to the area to speed up the removal of discoloration.
Nausea and Vomiting
If you experience nausea and/or vomiting after surgery, do not take anything by mouth for at least one hour (including the prescribed medicine). Then, sip on clear, carbonated beverages like ginger ale that have been allowed to go flat. Sip slowly over a fifteen-minute period. When the nausea subsides, you can eat solid foods and take the prescribed medicine again.
- If your lip, chin, or tongue is numb, there is no need to fear. As was explained before surgery, this is usually temporary. Be aware that if you bite your lip or tongue when they are numb, you may not feel it. Be careful.
- Immediately after surgery, the slight elevation of body temperature is not uncommon. If the raised temperature persists, call our office.
- Be careful when you stand up from lying down. Because you were not able to eat or drink before surgery, and it is difficult to take fluids, and taking pain medicine can make you dizzy, you may get light headed when you stand up suddenly. Sit for a minute before standing up.
- You may feel hard projections in the mouth with your tongue. These are not roots, but the bony walls which supported the tooth (or teeth). Projections usually smooth out on their own. If they don’t, they can be removed by our doctor.
- The corners of your mouth may dry out and crack if they are stretched. Keep your lips moist with an ointment like Vaseline.
- It is not uncommon to have a sore throat and pain when swallowing. The muscles get swollen and the normal act of swallowing can become painful. This will subside in 2 to 3 days.
- Stiffness (Trismus) of the aw muscles may cause difficulty in opening your mouth for a few days after surgery. This is normal and will resolve in time.
Sutures are placed in the treatment area to minimize post-operative bleeding and to promote healing. Sometimes sutures become dislodged, but this is no cause for alarm. Simply remove the suture from your mouth and discard it. The sutures will dissolve one to two weeks after surgery.
There will be a cavity (empty space) where the tooth was removed. Over the next month, the cavity will gradually fill in with new tissue. In the meantime, keep the area clean with salt water rinses or a toothbrush.
Dry socket occurs if the blood clot becomes prematurely dislodged from the tooth socket. Symptoms of dry socket include pain at the surgical site and even pain in the ear 2 to 3 days after surgery. Call our office if this occurs.