After Wisdom Tooth Removal

Proper home care following oral surgery will speed healing and help prevent complications.  Please follow these instructions carefully. They will help you to understand the normal reactions following your surgery and will help keep you as comfortable as possible.

Immediately Following Surgery  –  What to do when you get home!

  • Keep the patient awake until all bleeding has stopped.  If the patient is asleep, they are not clenching and the bleeding will not stop.
  • Keep clenching on the gauze until all bleeding is stopped.  The gauze must be positioned directly over the site of bleeding from the gums.
  • If there is bleeding from the sides of the gums, where gauze cannot reach, press the gauze against the bleeding area with your finger until stopped.
  • When the bleeding has stopped, remove the gauze and feed the patient.  If there is no further bleeding, leave the gauze out.
     If it is still bleeding  2 hours after surgery, remove the gauze, wipe the mouth out, feed the patient, administer pain medication, replace the gauze, and continue biting pressure to stop bleeding.
  • After the patient has food on his/her stomach, start oral pain medication.  DO NOT TAKE ANY PILLS ON AN EMPTY STOMACH.  Liquids alone are not adequate, you must eat something solid such as mashed potatoes, pasta, oatmeal, grits, eggs, etc. before taking any pills.
  • If the patient becomes nauseous or vomits, stop all pills until nausea passes.  Administer any over the counter nausea medication such as PeptoBismol or Emetrol.  Ginger-ale or coca-cola may also help.  Keep the patient still.  Call the office if a stronger nausea prescription is needed.
  • Apply ice packs to cheeks continuously while the patient is awake.  Change the ice packs every 20-30 minutes.  Continue ice until swelling and pain is gone, which may be several days.
  • Make sure you tell the patient all the instructions you were given.  They will be groggy in the office after surgery and WILL NOT REMEMBER.
  • Do not leave the patient alone with someone who did not read or hear these instructions.

BLEEDING

BITE ON THE GAUZE PACK PLACED IN YOUR MOUTH FOR AT LEAST ONE HOUR.

If bleeding continues after removing the pack, place a fresh gauze pack over the bleeding area and hold with clenching pressure for an additional hour. REPEAT AS NECESSARY. It often takes several hours of firm, continuous pressure to stop mouth bleeding. Once bleeding stops, the packing should be left out of the mouth.

Do not rinse, spit, or use a straw for 24 hours to prevent re-bleeding.

Do not go to sleep until bleeding has stopped.

Slight oozing producing a pink or red saliva is normal during the first 24 hours. However, if active bleeding recurs, it can be controlled by repeating biting pressure on the area. A tea bag may also be used, as the tannic acid in the tea promotes clotting. Applying ice packs and elevating your head will also help.

ACTIVITY

Rest for the first 2 days, and then adjust your activities to your level of comfort. Use common sense and don’t push yourself.   Do not drive while taking pain medication, and avoid strenuous exercise such as aerobics, jogging and weight lifting for 1 week.

PAIN

Discomfort is usually greatest during the first 24 to 48 hours. For mild discomfort, Tylenol or ibuprofen products should suffice. For more severe discomfort, use the medication prescribed for you. Use the anti-inflammatory pain medication ibuprofen/motrin around the clock and supplement as needed with the stronger pain medication prescribed to you.

All pain medication can upset an empty stomach. You can prevent this by eating before taking pain medications.

Apply ice packs to painful areas.

SWELLING

This is normal after surgery and will reach a maximum in about 3 days. Use ice packs during this time to help keep this to a minimum (20 minutes on, 20 minutes off). Swelling will start to resolve after 3 days.

ORAL HYGIENE

Rinsing your mouth is important to keep the surgery area clean and your mouth more comfortable, and should start the day after your surgery. Dissolve 1 teaspoon of salt in an 8 oz. glass of warm water. Rinse gently 8 – 10 times a day for two weeks. You may brush your teeth where comfortable, starting the day after surgery. Do not brush or run your tongue over the surgery area.

DO NOT SMOKE for at least 1 week following surgery. Nicotine and tobacco products delay healing and may cause infection and dry socket.

DIET

A soft diet with plenty of fluids is recommended after surgery.

Recommended foods are: milkshakes, smoothies, soup, juices, ice cream, eggs, mashed potatoes, pasta, apple sauce, oatmeal, grits, etc. Begin eating normally when chewing is comfortable. Rinse thoroughly every time after eating.

MEDICATION

Continue all other medications you were routinely taking before your surgery.

If antibiotics were prescribed, take as directed until finished. Take all prescribed medications with food.

Do not mix alcohol with any medication.

NAUSEA

Pain medication or antibiotics on an empty stomach, and swallowed blood may cause nausea and vomiting.

Do not take medications on an empty stomach.

If you become nauseous, you can settle your stomach with cola, ginger ale, or Pepto-Bismol. Limit yourself to clear liquids and bland food until it passes. If nausea persists, Dr. Rayner can prescribe medicine to help you. Do not take any more oral medication until the nausea has passed.

YOU MAY EXPERIENCE the following occurrences, which are normal:

  • Swelling around the surgical site.
  • Stiffness of the jaw muscles, which may cause difficulty in swallowing or opening the mouth.
  • A slight earache, or sore throat.
  • Pain in adjacent teeth or sensitivity to hot or cold.
  • Dryness or cracking of the lips. Your lips should be kept moist with an ointment such as Vaseline.
  • Loose stitches. Stitches will dissolve in about a week.
  • A slight elevation of your temperature for the first two days (up to 101 degrees).
  • Bruising on the side of the face or IV sites. Moist heat packs will help to resolve this.
  • Sharp bony edges after tooth extraction. These are not tooth roots and they disappear with time.
  • A hole where the tooth was removed. This will gradually fill in with time.

HOWEVER, IF YOU DEVELOP any of the following, call us:

  • Signs of infection – if after 3-4 days, you notice increased swelling, worsening pain, increased temperature, chills, or an objectionable odor and taste in your mouth.
  • Fever – Temperature of 101 degrees or higher (taken under the arm).
  • Profuse bleeding.
  • Increased pain (instead of improvement).
  • Any difficulty in breathing or any skin rash or itching.

PLEASE keep all scheduled post-operative appointments.

Dr. Rayner can be reached 24 hours a day: At the office: Clive B. Rayner, DMD Phone Number 904-269-5195   or on his cell at 904-318-3183

Please call if there are any questions.