Wisdom Teeth Extraction

Care of the mouth following a surgical procedure, especially during the first three days, is essential to the healing process. Do expect that there will be a certain amount of swelling, discoloration, discomfort, and bleeding.

If you were sedated:

  • You must not leave our office alone. You must, be accompanied by a responsible adult.
  • You may not drive or operate any vehicle or heavy equipment for 24 hours.
  • Women: Do not wear high heels or platform shoes.
  • Do get some assistance during the first day, when you walk to the bathroom.

Medications:

  • If antibiotics, steroids, or other medications were prescribed, do take them according to the instructions on the prescription bottle.
  • If you are able to take Ibuprofen (Advil) this has been found to be the most effective drug for pain control. You would have been directed to take 400mg prior to the surgery. Continue taking 400mg every six hours for the first two days.
  • If you cannot take non-steroidal anti-inflammatory drugs (NSAIDS eq. Advil or Alleve) then Tylenol can be used for pain management.
  • A prescription for a narcotic analgesic may have been prescribed. If so, take the drug as prescribed on the bottle, if Advil or Tylenol are not sufficient. Do not take pain medication on an empty stomach as it may cause nausea.
  • Some people have found Arnica to provide some relief of swelling and bruising. This can be found at health stores. Apply this lotion to the outside of the face in the surgical area. Do not take Arnica orally.
  • Avoid the use of alcohol, smoking or carbonated drinks for the first 48 hours after surgery. This may interfere with clot formation and slow the healing process
  • NOTE: Antibiotics may decrease the effectiveness of birth control medications. Additional methods of birth control should be used while on antibiotics

Your dietary needs:

  • Do not consume hot liquids for 72 hours.
  • Do not try to eat solid foods until the local anesthetic wears off, as you might bite your tongue or cheeks.
  • Do not use a straw when taking in liquids. The suction action may dislodge a clot.
  • Your food intake will be limited for the first few days. You should compensate for this by increasing your fluid intake. At least 5-6 glasses of liquid should be taken daily. Try not to miss a single meal. A nutritious diet throughout your healing stage is important to your comfort, temperament, and healing. The diet for the first four days should be relatively soft foods. Be sure to chew away for the surgical area.
  • Increase Vitamin C intake.
  • 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 for one minute before standing.

Bleeding:

  • A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon and can continue for several hours. Avoid spitting and the use of a straw as they may provoke oozing.
  • Excessive bleeding may be controlled by first gently rinsing your mouth with cold water, then placing a gauze pad over the area and biting firmly for thirty minutes. Repeat if necessary.
  • If bleeding continues, bite on a moistened, squeeze dried tea bag for sixty minutes, repeat as necessary. The tannic acid in the tea bag helps to form a clot by contracting bleeding vessels.
  • To minimize further bleeding, do not become excited, sit upright, and avoid exercise. If bleeding is still occurring 3-4 hours later, and the above measures have been taken, call this office immediately.
  • Do not forcefully swish when rinsing as this can dislodge the blood clot.
  • Do not exercise for 72 hours. Strenuous activity will increase your blood pressure and may dislodge the blood clot.

Swelling:

  • Swelling is part of the healing process and can be expected for several days. The swelling that is normally expected is usually 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 and eventual repair.
  • The swelling may not become apparent until the day following surgery and will not reach its maximum until 2-3 days post-operatively. However, the swelling may be minimized by the immediate use of ice packs. Two baggies filled with ice, or ice packs should be applied to the sides of the face where surgery was performed. The ice packs should be applied in 15 minute intervals continuously while you are awake.
  • After 48 hours, ice has no beneficial effect. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery.
  • Forty eight hours following surgery, the application of moist heat to the sides of the face is beneficial in reducing the size of swelling.

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. Also, the use of Arnica lotion can assist with this discoloration.

Other Issues:
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.

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.

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 two weeks after surgery. The removal of sutures requires no anesthesia or needles. It takes only a minut or so, and there is no discomfort associated with this procedure. So it’s really nothing to worry about.

When you should notify Dr. Dougherty:

  • If profuse bleeding continues after 3 - 4 hours of applied pressure.
  • If you are unable to maintain a nutritious diet after 48 hours.
  • If pain or swelling increase after the third day.
  • If the sutures become loose or dislodged prior to the third day.
  • If an oral bandage or dressing that was placed becomes dislodged prior to the third day.
  • If your body temperature remains higher than 100 degrees F. taken orally after the third day.
  • If you have any symptoms which may indicate a reaction or allergy to the medications, such as:
    • Skin rash
    • Hives
    • Elevated temperature
    • Increased or erratic heart rate
    • Nausea/vomiting
    • Dizziness
    • Blurred vision

Remember no question is too small and we are just a phone call away: 301-530-2434.

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