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After Extraction of Wisdom Teeth

Day of Surgery
  1. Bite on gauze steadily for one hour then replace it with lightly moistened gauze every hour until the bleeding stops.  The gauze pad should be rolled tightly and placed directly on the extraction socket and pressure applied steadily.  Bleeding usually stops in 3-4 hours.  It is normal for the socket to ooze on and off from several days.  If bleeding persists more than 4 hours, bite on a moistened tea bag.

  2. Medications: If you were given antibiotics, start taking them once you know you are not having nausea from the surgery or pain pills and you have had a chance to eat something.

  3. Pain: the most common complaint after having teeth removed is that the surgical site is painful for several days after surgery.  Although we cannot guarantee you will be pain free after surgery, steps can be taken to improve the level of pain control.  The pain is typically most dramatic 3-5 days after surgery.  It is normal to need to take pain medication for 5-7 days after a tooth is removed (or even longer for difficult teeth or if you are older).  You will be given a prescription for a narcotic medication.  We recommend you also begin a regimen of ibuprofen (Motrin, Advil, Nuprin) unless your doctor advises you against this.  You can get this at the pharmacy without a prescription.  It comes as 200mg tablets.  As soon as you can eat after surgery, take 2-3 tablets of ibuprofen.  Continue taking 2-3 tablets every 6-8 hours for 5-7 days after surgery.  As soon as you feel the local anesthesia wearing off (tingling in your lip), take one tablet of the narcotic pain medication that we wrote a prescription for.  After that, take the prescription medication if you have pain that the ibuprofen is not handling.  It is important to stay “ahead” of the pain, so take medications early in the pain course rather than waiting until it is severe.  You can take up to 2 tablets of the narcotic medication every 4 hours if needed.  Please call if you have any concerns.

  4. Try not to lie down flat today.  If you need to nap, do it sitting up in a chair or recliner.  Lying down will lead to more swelling, bleeding, and pain.  We recommend you either sleep in a chair with your head up or propped up with several pillows in bed.  The general rule is that if you had pain during the day, sleep with your head elevated that night. 

  5. Eat a soft diet such as ice cream, yogurt, pudding, pasta, eggs, etc. until the local anesthesia wears off.  Keep drinking fluids throughout your recovery.  Hydration is critical for proper healing.

  6. Ice: For the first 24 hours after surgery, place ice on the side(s) of your face that had the tooth (teeth) removed.  This can decrease pain and swelling.  We recommend placing ice on your face for 20 minutes then taking it off for 10 minutes.  After 24 hours, the ice should be discontinued and heat may be placed on your face if desired.  Use a rice pack or moist heat if possible.  Continue heat until the swelling has gone away.  This may take 4-7 days.
Day After Surgery
  1. The next morning it is important to get up and start relieving the selling that occurred overnight.  Start with a shower and shampoo and then lightly stretch your mouth with your fingers if it is stiff.  Brush your teeth very gently near the extraction sites and normally everywhere else.  You may find warm water will make the bristles softer and more comfortable in the extraction areas.  Rinse gently to rinse out the toothpaste.  Warm salt water rinses should begin 24-48 hours after surgery.  Do not use commercial mouth rinses such as Listerine, Scope, or hydrogen peroxide.  These solutions can delay healing.
  2. Eat soft, solid, high calorie food the day after surgery if you are comfortable chewing.  Take small bites and chew in an area away from the extraction sites.  Good nutrition promotes healing.
  3. Walk around doing light activity to help decrease the swelling.  This will also promote better breathing.
  4. If you have stitches, they will dissolve on their own, and you do not have to come back to the office if you think you are doing well.
  5. If you have moderate to severe pain that is persisting or increasing after 5-7 days from surgery or if you have any questions, please call our office.

Instructions for Specific Concerns
  1. Discomfort: Postoperative pain is most severe 3-5 days after surgery.  The narcotic pain pills prescribed for you will help decrease this pain but may not totally eliminate it.  Narcotic pain medications may upset your stomach.  This side effect can be lessened if you eat something substantial before taking the medication.  Pain usually decreases beginning on day 5 or so and may be managed with ibuprofen or similar over-the-counter medication.  Stay “ahead” of your pain by taking your pain medication when the pain is mild rather than waiting until it is severe.  Smoking will greatly increase your pain.

  2. Bleeding: Some oozing is to be expected after oral surgery.  Biting on gauze with firm, steady pressure for 1 hour after surgery will usually be enough to stop continuous bleeding.  If brisk bleeding continues, place a fresh, cold, tightly-rolled, dampened gauze pad directly over the bleeding area and bite firmly and continuously for another 60 minutes.  If bleeding persists, biting on a moistened tea bag wrapped in gauze may stop the bleeding.

  3. Swelling: Some swelling is normal following oral surgery.  Maximum swelling is usually 4-5 days after surgery.  Putting an ice bag intermittently on the face on the day of surgery limits this swelling and makes it feel better.  Ice used after 24 hours from surgery will generally increase your pain.  Beginning the day after surgery, moist heat to the face may help reduce swelling and soreness.  An elevated body temperature may occur during the first two days after surgery.

  4. Stiffness: It is common for the jaw muscles to stiffen up by the morning after surgery.  This should be overcome with gentle finger pressure between the front teeth the first morning after surgery.  If you wait for 2-3 days to stretch the mouth open it is generally more difficult and painful to do.

  5. Diet: High fluid intake is essential.  Your urine should be clear and frequent (every 2-4 hours).  Eat nourishing, soft, high calorie foods such as cottage cheese, creamy soups, milk shakes, ice cream, pudding, yogurt, egg salad, tuna fish, or pasta.

  6. Rinsing: Do not vigorously rinse your mouth until at least the day after surgery.  Beginning the following morning, you should brush your teeth and rinse gently with tap water to remove the toothpaste.  Beginning no earlier than 24 hours after surgery, rinse your mouth gently with warm salt water several times a day.  Salt water solution is made by adding only a few dashes of salt to a glass of warm water.

  1. Don’t suck through a straw for 3-5 days.
  2. Don’t rinse with commercial mouth washes or hydrogen peroxide for at least 1 week.
  3. Don’t do strenuous exercises for 5-7 days
  4. Don’t smoke for at least 7 days after surgery and longer if you are having any postoperative pain.

If, after your procedure, you have any questions or concerns please feel free to contact us at 574-272-8823.