After Wisdom Tooth Removal

Sometimes the after-effects of oral surgery area quite minimal, so not all of the following instructions may apply.  When in doubt, follow these guidelines or call the office for clarification.

The office phone number is Ballard Oral Surgery Phone Number 206-783-9672.

DAY OF THE PROCEDURE:

• Avoid disturbing the surgical site.
• You may have surgical packing in place.  Do not disturb it.  If it becomes loose or dislodged, do not be alarmed.  Call the office for further instructions.
• You may have a chain or appliance visible.  If the chain becomes loose or dangling, do not worry.  Call the office for additional instructions.
• Do not rinse vigorously or probe the surgical site (this may cause bleeding or irritation).
• You may brush your teeth gently, avoiding the surgical site.
• Do not smoke.
• Avoid straws.

FIRST HOUR AFTER SURGERY:

• Bite down firmly on the gauze that is in your mouth.  Firm pressure helps bleeding to stop.
• Keep the gauze in place for an hour.
• If there is still active bleeding, replace the gauze and bite down for another 30-45 minutes.
• Do not change the gauze more frequently, as this may cause more bleeding.
• Intermittent bleeding or mild oozing is normal.
• Place ice packs on your face, adjacent to the surgical area, 20 minutes on and 20 minutes off.

SECOND HOUR AFTER SURGERY:

• Eat something cool and soft before taking pain medication.
• Taking pain medication on an empty stomach may cause nausea and/or vomiting.
• Take medications only as directed.
• Avoid hot drinks and food, as this may cause more swelling and bleeding.

REMAINDER OF THE FIRST DAY:

• It is likely that pain medication will be needed for the first day or two after surgery.
• Avoid strenuous activity.

24 HOURS POST-SURGERY:

• Keep your mouth clean.  Begin gently rinsing with warm salt water after meals.  Use ½ to 1 teaspoon of salt dissolved in an 8 ounce glass of warm water to make the solution.
• Salt water rinses 2-3 times per day, for 2-3 weeks.
• Avoid using an electric toothbrush in the surgical area for one week.

POST SURGICAL DAYS 3 AND 4:

• You may notice additional swelling, which should start to improve by the 5th day after surgery.
• If the narcotic pain medication is more than you need, you may transition to over the counter analgesics (pain medication).

DAYS 5-14 POST-OP:

Your symptoms should continue to improve.

You may require a post-op visit, which will provide additional instructions on oral hygiene, if needed.

PERSISTENT BLEEDING:

• Bleeding should never be severe.
• If bleeding persists, ensure that the gauze packs are placing pressure on the surgical site.
• If bleeding continues, place a moist black tea bag on the surgical site and bite down, applying pressure for 30-45 minutes.
• If you are unable to control bleeding, please call the office.

ANTIBIOTICS:

• You may be prescribed a course of antibiotics, depending on the procedure.
• Pain medication and antibiotics may be taken at the same time.
• For female patients: some antibiotics interact with oral contraceptives (birth control pills), reducing their effectiveness.  Use alternate forms of contraception for one month after completing your course of antibiotics

DISCOMFORT:

• A prescription for pain medication may be provided.
• Discomfort is best managed if the first dose of pain medication is taken before the numbness wears off.
• Pain medication may cause nausea.  To avoid nausea, take the medication with food.
• If there are no contraindications, you may take ibuprofen 600mg every six hours, in addition to the prescription medication.
• If you find you are taking large amounts of pain medication at frequent intervals, please call the office.
• Narcotic pain medication may cause drowsiness.  Do not drive or operate machinery while taking these medications.

SWELLING:

• Many patients have swelling after oral surgery.
• For the first 2-3 days, keep your head elevated when sleeping to minimize swelling.
• Use of ice packs will help the swelling.  Place the pack on the site for 20 minutes, then remove for 20 minutes.  The cold pack should be wrapped in a cloth or a towel.
• Ice packs help the most during the first 24 hours after surgery.
• The most swelling is seen on the second or third day after surgery.

DIET:

• Maintain a soft food diet, such as ice cream, pudding, yogurt, applesauce, soup, etc.
• Avoid popcorn, nuts, chips, etc.
• Over the next several days, you may gradually advance your diet to solid foods.
• Do not skip meals.
• Remember to eat when taking pain medication.
• If you are diabetic, maintain your normal eating habits or follow instructions given by your doctor.

NAUSEA:

• It is not uncommon to have nausea after oral surgery.  This may happen if a small amount of blood is swallowed.
• Pain medications may cause nausea, especially if taken on an empty stomach.
• Nausea may be relieved with soda, 7-up, ginger ale, or tea.
• If nausea/vomiting persists, repeat fluid intake once or twice.
• For unrelenting nausea/vomiting, please call the office.

LAXATIVES:

• Some narcotic pain medication may cause constipation.
• An over-the-counter stool softener/laxative may be needed.  Consult your pharmacist for recommendations based on your specific situation.

DISCOLORATION:

• Bruising is not uncommon after oral surgery, especially if you bruise easily or are taking certain medications.
• Bruising generally lasts 5-6 days and will resolve spontaneously.

SINUS INSTRUCTIONS:

Occasionally teeth/implants are close to the maxillary sinus.  If this is your situation please take note of these instructions.

• You may have a slight nosebleed for several days.
• Take medications as prescribed.
• Refrain from blowing your nose for two weeks.
• Try not to sneeze or cause pressure in your mouth or nose.  If you must sneeze, sneeze with your mouth open.
• Do not use a straw or smoke.  Smokeless tobacco should also be avoided.
• Eat soft foods and chew on the opposite side.
• Do not rinse your mouth vigorously.
• Follow up as appointed to evaluate healing.