After Wisdom Tooth Removal

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 and/or oozing should be expected for the first 24 hours. If the bleeding gets heavy, it can be controlled with use of the gauze provided to you. The gauze should be moistened with tap water and placed directly over the surgical wound. When you bite your teeth together, you should have some pain with it as we are trying to get pressure on the wound itself. If it is not hurting you a little bit, you probably do not have it over the wound. You should hold steady pressure on the wound for 20 minutes. If you are not biting on the gauze, do not have it in your mouth. Do not eat or sleep with the gauze in your mouth. As an alternative, a moistened tea bag can be substituted for the gauze using the same technique as described above. If the bleeding persists, you should call Dr. Kisella at the number you were given.

Swelling

Swelling is a normal part of the postoperative period proportional to the surgery involved. Swelling around the mouth, cheeks, eyes, and sides of the face is not uncommon. This is the body’s normal reaction to surgery. The swelling will not become apparent until the day following surgery and will reach its maximum on day 3 post-operatively. The swelling may be minimized by the immediate use of ice packs that we provide you.  The ice packs should be left on continuously while you are awake. After 48 hours, ice has no beneficial effect. After 48 hours, the application of heat to the sides of the face is beneficial in reducing the size of the swelling. The packs provided can also be used for heat. You should expect a decreased ability to open your mouth after the surgery. This is due to irritation of the muscles that open your jaw. As the pain and swelling subside, your opening will increase. It may take 2 weeks or more to get back to normal.

Pain

This is a normal part of any surgical procedure. The third to fourth day will be the worst day of pain. It will take approximately 2 weeks to feel as though you had nothing done and to be able to eat whatever you want. The baseline pain medication will consist of Motrin and/or Tylenol. These should be taken three times a day with food for a minimum of 5 days. They may be needed for up to 2 weeks. An opioid will be prescribed in a limited quantity. They are to be used to address pain that is not relieved by the Motrin and/or Tylenol, and are to be taken on an as needed basis. You should not drive, operate heavy machinery, or drink alcohol while taking an opioid. If the pain persists, you should call Dr. Kisella at the number given to you.

Bruising 

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.

Nausea and Vomiting

In the event of nausea and/or vomiting following surgery, do not take anything by mouth for at least an hour, including the prescribed medicine. You should then 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.

Diet

Your initial diet should consist of liquids, which should be advance to a soft diet as tolerated the first day. You are to avoid hard foods and the use of straws for one week. You should gently rinse your mouth out after eating to help keep the surgical sites clean.

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 Dr. Kisella 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 Dr. Kisella.
  • 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.
  • Sore throats and pain when swallowing are not uncommon. The muscles get swollen. The normal act of swallowing can then become painful.
  • Stiffness (Trismus) of the jaw muscles may cause difficulty in opening your mouth following surgery. This is a normal post-operative event which will resolve in time.

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 will be removed approximately one week after surgery.

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. A syringe will be provided to you at your follow-up visit to keep the area clean.

Brushing and flossing your teeth is okay – just be gentle at the surgical sites.

If you are involved in regular exercise, you may resume these activities the day after surgery. Please use your best judgement with the intensity of these activities.